A nurse thought “not again” when a baby suddenly collapsed on a second successive night at a neonatal unit, jurors at a murder trial have heard.

The infant’s twin brother had deteriorated rapidly the evening before and died at the Countess of Chester Hospital’s neonatal unit despite efforts to revive him.

It is alleged nurse Lucy Letby, 32 and from Hereford, injected air into the bloodstream of the newborn, Child A, shortly after she came on shift on June 8 2015, just over 24 hours after his premature birth.

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The Crown alleges she used the same method to attack his sister, Child B, on the following night shift.

Giving evidence at Manchester Crown Court on Monday, a nursing colleague of Letby recalled she was preparing medicines when the monitor alarm sounded at Child B’s incubator.

The nurse – who cannot be identified for legal reasons – said Letby was the first to go to the cot and she called her for help.

Asked about Child B’s appearance, she said: “She looked very ill. She looked very like her brother did the night before. Pale, white, with this purple blotchy discolouration. It was all over her body.

“I just remember thinking ‘not again’ – to see his sister with the same appearance.”

A breathing tube was inserted and Child B “started to stabilise quite quickly”, said the witness giving evidence screened from the public gallery and the defendant.

The nurse went on: “(Child A’s) deterioration was very sudden and to an unusual degree. Babies can be very poorly quickly but there is usually some indication that is happening. We had no undue concerns.

“To go from that is very unusual and then (Child B) had been good throughout the evening for me … then she became ill very quickly. She deteriorated very quickly and then this discolouration.

“You never want any baby to die. You want to help them go home to their families. That’s always been my goal.”

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Child B recovered and was eventually discharged a month later, the court has heard.

The witness could not explain why when interviewed by police in 2018 she had not mentioned an unusual discolouration in Child A’s appearance but when later questioned about Child B she said her discoloured skin was similar to her brother.

She told Ben Myers KC, defending, that people on the unit were talking at the time about rashes but she was not influenced by anything somebody said.

The nurse told the jury she could not remember who administered intravenous fluids to Child A shortly before his collapse but accepted she told police that another nursing colleague had “pressed start” in the process and Letby assisted with checks.

She said she acted as “mentor” to Letby, who first came to the unit as a trainee around 2010/11 while studying at the University of Chester.

They became “good friends”, she said, as Letby went on to join the unit after she qualified.

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Mr Myers said: “We know the allegations but your experience when working with her was she was highly professional?

“Yes,” replied the witness.

Mr Myers said: “And dedicated to the work she was doing?”

“Yes,” agreed the witness.

Letby denies the murders of seven babies and the attempted murders of 10 others while she worked at the neonatal unit between June 2015 and June 2016.

A court order prohibits reporting of the identities of surviving and dead children allegedly attacked by Letby, and also prohibits identifying parents or witnesses connected with the children.

The trial continues.