Those aspects were reflected in a lengthy victim impact statement read to the court today by the boy's mother. She said her boy must have endured "excruciating" pain as he underwent lumbar puncture proceedings amid suspected meningitis at his first admission to hospital, and later as pressure developed on his brain after the second incident.
No one knew what was wrong, except Elstone, she said.
Starship and two years after the incidents still suffered effects and frequent falls unusual for a child of his age. He also carried scars that would be a "permanent reminder" of the the assaults.
The impact on the family was significant.
"It broke us," said the mother, who cannot be identified because of a permanent suppression order.
Both of the mother's boys had been in the care of Elstone, who the judge observed had been found to have been not coping and was probably unsuitable for the care role at the time of the incidents in January 2017.
The trial was told Elstone was the only adult with the baby boy on the two occasions he was assaulted, and Judge Rea said that despite the denials the evidence pointed directly to Elstone and the "acceleration" and "deceleration" which would have caused the injuries.
On January 9, 2017, the child, only recently put into Elstone's care, was rushed to Hawke's Bay Hospital after showing signs of a seizure. His condition was put down to an infection and he was later released.
The same happened again on January 24, when the child, pale and limp, was rushed to the hospital and then transported to Starship children's hospital, in Auckland, for brain surgery.
He was treated for a subdural haematoma - a serious condition where blood collects between the skull and the surface of the brain. It was there that doctors discovered he had previously suffered a similar serious head injury.
During the trial several medical experts told the court the injuries, which were compared to that of a car crash or a serious fall, were not accidental.
A tearful Elstone continued to deny the allegations and said she had no idea how the first injury occurred on January 9.
She said it was possible the second injury was caused by the baby's 2-year-old brother falling on him while he was in a bouncer-net, but the claim was rejected by medical experts.
Crown prosecutor Steve Manning said the boy was "happy and healthy" before entering Elstone's care in 2017.
"She's shaken this child or used force in some way," he said.
Defence counsel Nicola Graham said the baby did not have external injuries and there was no definite cause for the brain injuries. She told the court that it would be unusual for someone to injure a baby and then take it back into their care.
