Dr Joseph Medson said a gentle shaking, or a fall on to towels on a bathroom floor as Ms Woodward is alleged to have told police happened, could not have caused the irreversible brain damage from which Matthew Eappen died five days after his admission to hospital in Boston.
Gerry Leone, for the prosecution, asked Dr Medson on the second day of the 19-year-old's trial at the Middlesex Superior Court in Cambridge, Massachusetts: "In your opinion, was the cause of these injuries accidental or non-accidental?"
He replied: "I think they were non-accidental ... it would have required a forcible hitting of the head against some blunt surface. To explain the haemorrhaging there would have to be an additional shaking or swinging of the head."
Ms Woodward, of Elton, near Chester, denies murdering the baby in what the prosecution alleges was a "frustrated, unhappy and resentful" rage because he would not stop crying and because she was unhappy with her job with Matthew's parents. She faces a life sentence without parole if convicted.
Dr Medson said he also ruled out the brain damage being caused by a developing, existing condition from an older injury. He estimated the injuries to Matthew had been caused between one to three hours before his admission to hospital on 4 February. He said after suffering such injuries Matthew would have appeared lethargic, sleepy, probably been vomiting, lost his appetite and appeared generally abnormal.
The defence claims the baby was showing these signs during the whole day and had not appeared his normal self the previous day. The case continuesReuse content