Lucy Letby will spend the rest of her life in jail for the "evil" murders and attempted murders of babies at the hospital where she worked.
The most prolific child serial killer in modern British history was convicted by a jury of murdering seven babies and trying to kill six more while working at the Countess of Chester Hospital neonatal unit between 2015 and 2016.
Mr Justice Goss told the 33-year-old there was "premeditation, calculation and cunning in your actions" as he handed down a whole-life order at Manchester Crown Court on Monday.
Addressing the nurse, who refused to appear in court, he said: "You acted in a way that was completely contrary to the normal human instincts of nurturing and caring for babies and in gross breach of the trust that all citizens place in those who work in the medical and caring professions.
"The babies you harmed were born prematurely and some were at risk of not surviving but in each case you deliberately harmed them, intending to kill them."
The judge told her she would be provided copies of his remarks and the personal statements of the families of her victims.
Earlier, the families of Letby's victims addressed an empty dock as they told her "you are nothing" and "you are evil".
More than a dozen relatives of Letby's victims sat in the public gallery for the hearing on Monday and eight jurors returned to see the sentencing.
The mother of Child E, a premature-born boy who died, and Child F, his twin brother who survived, told the court the nurse's refusal to appear was "just one final act of wickedness from a coward".
Letby has become only the fourth woman in UK history to be told she will never be released from prison.
These include the girlfriend of Moors murderer Ian Brady, Myra Hindley, who died in 2002, and serial killers Rose West and Joanna Dennehy.
Labour leader Sir Keir Starmer said he shared the victims' families anger about not seeing Lucy Letby in the dock for her sentencing hearing as he urged the Government to change the law to compel criminals to attend.
The Labour leader told journalists: "What I don't think should be allowed to happen is for the Government to say because there are practical considerations, which of course there are, we'll do nothing about it.
"Just think of those victims' families today not seeing the defendant in the dock facing justice as she properly should. They are angry, they're frustrated. I share that.
"I saw for myself just how important it is. So from our position, we're thinking not about party politics. We're thinking about the victims, making an absolutely open offer to the Government, we'll work with you, overcome the practical considerations, and let's get this done, let's get the law changed."