Row over 'no smile' girl's life support

Generic image of a baby's hand
Image caption Doctors said the emergence of a smile in a baby was an indicator of cognitive function

A seriously-ill baby who a specialist said does not seem able to smile is at the centre of a High Court life-support treatment dispute.

The six-month-old girl - who is in the care of Nottingham City Council - has a range of health problems and has never left hospital, a judge heard.

Doctors want to put her into palliative care as the burden of life support treatment outweighed any benefits.

The council disagreed and said she should undergo surgical procedures.

'Bleak prognosis'

A specialist, from Nottingham University Hospitals NHS Trust, told Mr Justice Keehan at the hearing, that the girl, who cannot be identified, could not make "meaningful" noise and did not seem able to smile.

He said babies initially acted on instinct and the emergence of a smile was an indicator of cognitive function.

He told the judge: "The first evidence that there is actually someone inside there is when a baby looks at something which it thinks is a face, processes that face and then smiles."

He said long-term treatment would place "significant burdens" on the little girl.

The girl was likely to need long-term respiratory support or ventilation, a tracheostomy and a feeding tube, the trust said.

However, lawyers acting on behalf of city council told the judge it was too early to conclude that she will not be able to derive benefit from continued life.

Barrister Lawrence Messling, who led the council's legal team, told Mr Justice Keehan, the council has experience of other children who have "confounded that initial very bleak prognosis".

The authority wants the girl to undergo "surgical procedures" and then be placed with a foster carer.

The judge was told that the baby's mother had health difficulties.

Her father said he did not want his daughter to "suffer unnecessarily" but did not "feel able to express a position" about the "appropriate way forward".

The hearing is due to continue later.

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