The serial killer nurse Lucy Letby will never be released from prison after a judge sentenced her to a rare whole-life term for the “sadistic” murder of seven babies.

Letby, 33, is one of only three women alive to have been given such a jail term in the UK. She was sentenced at Manchester crown court on Monday.

The former neonatal nurse, the worst child serial killer in modern British history, was also convicted of attempting to murder six more babies at the Countess of Chester hospital.

Sentencing Letby, Mr Justice Goss described her crimes as a “cruel, calculated and cynical campaign of child murder involving the smallest and most vulnerable of children”.

Letby knew her actions were “causing significant physical suffering and would cause untold mental suffering”, the judge said. “There was a deep malevolence bordering on sadism in your actions.”

The judge said she “acted in a way that was completely contrary to the normal human instincts of nurturing and caring for babies”. Goss said her claims to have done her best in caring for babies was “one of many lies” she told throughout the trial. “There is no doubt that you are intelligent and outwardly were a very conscientious, hardworking, knowledgable nurse – which enabled you to harm babies for some time.”

The trial had heard how Letby often attacked the infants just moments after their parents or nurses had left their sides. She fatally injected seven babies with air, tried to kill two others by lacing their feeding bags with insulin and attempted to murder one by thrusting a nasogastric tube down his throat.

Letby had a “detached enthusiasm” for the resuscitation of babies fighting for life, the judge said, adding that she “cruelly and callously” made inappropriate remarks to parents or colleagues during or after a death. She kept hundreds of medical documents as “morbid records of the dreadful events surrounding your victims and what you had done to them”, the court heard.

Goss said it was not for him to “reach conclusions about the underlying reasons” for Letby’s actions. “Nor could I,” he added. “For they are known only to you.”

He added: “Loving parents have been robbed of their cherished children and others have to live with the physical and mental consequences of your actions. Siblings have been deprived of brothers and sisters. You have caused deep psychological trauma, brought enduring grief and feelings of guilt, caused strains in relationships and disruption to the lives of all the families of all your victims.”

Letby refused to be present in court for the sentencing, in which parents of her victims described in powerful detail the impact of her crimes. Goss ordered her to be provided with a copy of the sentencing remarks and of the victim impact statements in her absence.

In one statement, the mother of a baby murdered on his fourth day alive, Child C, said she felt it was like watching someone else’s life as her son died. Holding back tears in court, she said: “The trauma of us all will live with us all until we die. Learning that his killer was watching us [as we grieved] is like something out of a horror story.”

She said she would “live forever with the guilt” that she was not able to protect him: “I think about what his voice would have sounded like. What he would have looked like now. Who he would have been.”

Whole-life orders are reserved for crimes of exceptional gravity.

The other two women serving whole-life terms are Rose West, who tortured and killed at least nine young women in the 1970s and 1980s, and Joanna Dennehy, who murdered three men in what came to be known as the Peterborough ditch murders in 2013.

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