Melissa Clark, 46, is in trial this week charged with first degree murder.
In July 2016, a child was reported as unresponsive from Clark's at-home day care in Noble, Oklahoma. 4-month-old Braelyn Zachary was eventually transferred to St. Francis Hospital in Tulsa where she died.
According to affidavits, Clark admitted to dropping Braelyn and throwing her at a bouncy seat when she was stressed. She was watching other children at the same time.
During testimony on Thursday in court, a neurosurgeon testified that Braelyn arrived at the hospital in a coma with swelling in her brain. A pediatric resident confirmed that Braelyn would not have been able to breathe without a ventilator.
A Tulsa medical examiner also testified on the autopsy he performed. He said Braelyn died by cause of blunt force trauma in the manner of homicide.
Photos of Braelyn were shown, leaving her family members emotional during the testimony. At one point, her parents left the courtroom.
More witnesses will be called by the state on Friday.