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The mother of a child who was so malnourished she weighed less than 5kg aged 19 months faced court on Thursday

The foster carer who took charge of a severely malnourished toddler fed an extreme vegan diet was appalled when she first saw the child in hospital.

'When I first met [the child] she was nearly two years old and looked like a three-month-old baby,' the mother-of-five told a court.

'She weighed 4.89kg and had no teeth. My own babies weighed over 4kg when they were born.

'She was lying in her hospital bed with tubes covering her tiny body. She was being fed by a tube through her nose.

'I remember thinking how terrifying this must be for such a small child.'

The toddler, who was in intensive care after suffering a seizure, could not even roll over, let alone stand, walk or talk.

Her parents, who fed the girl a meagre vegan diet and did not have her immunised, have admitted failing to provide the child with the necessities of life and face a maximum five years in jail.

How did a seemingly respectable young couple living in Sydney's eastern suburbs and successfully raising two other children end up starving their little girl?

The identities of the parents – they are no longer a couple - are suppressed to protect their children but details of how their daughter came to suffer Third World illnesses have gradually been revealed. 

A mother and father who starved their daughter on a meagre vegan diet for the first 19 months of her life are facing up to five years in jail. The Sydney couple, who cannot be named so as to protect their children, admit they were reckless but deny intentionally harming their child

This 19-month-old girl looked more like a three-month-old and weighed less than 5kg when she was taken to hospital in March last year. She was fed an extreme vegan diet by her parents 

The couple had been living in a neat terrace in a quiet Sydney neighbourhood when they were arrested on April 6 last year. The mother was 31 and the father 33.

Former neighbours at that property and another where they had previously lived told Daily Mail Australia they had never seen the baby girl. 

'We got the shock of our life when the police told us there was a baby in there,' one neighbour said.

That neighbour, who had only seen two boys in the years the family lived near him, described the father as quiet but pleasant.

'He seemed a nice style of a fellow,' he said.

The couple's last home was a well-maintained terrace which was rented for about $1,000 a week and the father's BMW was often parked out the front.

One of their neighbours at that address often saw the father but not the mother.

'He just seemed like a normal working person,' that neighbour recalled. 'I've never seen a woman in there. Never ever. You don't see any sort of movement in there.'

Those former neighbours were shocked when the parents first appeared at Waverley Local Court where they initially denied starving their youngest child.

The charge was that they each 'did have parental responsibility for [the child] and without reasonable excuse, recklessly failed to provide for [the child] with the necessities of life, which caused a danger of serious injury to [the child].'

The father, 35, and mother, 32, of a toddler who was so malnourished she was suffering from rickets have pleaded guilty to not providing for the girl. While they held hands when they first appeared in court the couple has now split and their three children are in foster care

The child, who was diagnosed with the degenerative bone disease rickets after being taken to hospital for the first time since her birth, is pictured above in an intensive care hospital bed

Police said the parents fed their daughter a strict diet 'severely lacking in nutrients for her to thrive' and stated the baby's height and weight were 'markedly below expected' for her age.

The offences occurred over 20 months between the child's birth in July 2016 and her being taken to hospital on March 10 last year, at their two homes in Sydney's east and south.

It was that visit to hospital after the child suffered a seizure which led to an investigation by detectives from the State Crime Command's Child Abuse and Sex Crimes Squad.

The infant had fractures throughout her tiny body and her bones were so brittle doctors believed they could have been broken by 'normal handling'.

Doctors found the girl's levels of vitamin D - which can cause bone disease if found to be too low - were 'undetectable'. She also had no teeth.

The mother told a hospital dietitian her entire family followed a vegan diet and detailed the extreme eating measures that led to the girl's condition.

She said her daughter, who was breastfed once a day, would generally have one cup of oats with rice milk and half a banana in the morning, and a piece of toast with jam or peanut butter for lunch.

For dinner, she would be offered tofu, potatoes or rice but the girl was a 'fussy eater' so she might just have oats again.

Sometimes for a snack the child was given a mouthful of fruit or two sultanas.

The toddler could not crawl or even roll over when first taken to hospital.  She has now learnt to stand and walk after intensive rehabilitation but is a long way from making a full recovery

This diet resulted in severe deficiencies in nutrients for the infant, including a lack of calcium, phosphate, vitamin B12, vitamin A, iron and zinc.

The child was diagnosed with rickets, a degenerative bone disease caused by a shortage of vital nutrients.

Crown prosecutor Julia Dewhurst later said such serious malnourishment in a child was extremely rare in Australia and was more likely to be seen in the Third World. 

Hospital staff initially respected the parents' wishes to keep the infant on a vegan diet, but grew concerned when the mother outlawed soy because it was full of 'hormones'.

Even after the girl had been in hospital for a week, the parents exchanged text messages denying their daughter's lack of growth was a result of malnutrition.

When police asked the father why he wasn't concerned his daughter was not growing normally he said she was just petite, and girls grew differently to boys.

Police learnt there was little documentary evidence the girl existed; there were no medical records after she left hospital in 2016 when she was born in 'good condition'.

The mother had a water birth and discharged herself just three and a half hours after delivery. She returned for a post-natal check three days later.

However, the mother then refused a newborn eyesight and hearing checks, telling doctors she would rather her GP do them.

She never saw the GP for the tests and ignored multiple phone calls, voicemails, text messages and a letter for two weeks.

The girl had never been immunised, had no birth certificate and no Medicare number.

The baby was never taken to a doctor until she suffered the seizure, when the mother called Triple 0.

In hospital a doctor described the child as 'floppy' and noted how she did not crawl or talk during a month in care.

The carer who later took custody of the girl described in a victim impact statement written on her behalf what she saw in hospital.

'I was shocked by how far behind [the girl] was compared to other children her age I had looked after,' she said.

The girl is now considered obese because her height and weight are so out of proportion 

'They had been able to run around, talk to you and play games.

'Caring for [the girl] was like caring for a very young baby. She couldn't sit up. She couldn't speak any words. She couldn't feed herself or hold her bottle. She couldn't play with toys.

'She was not interactive and spent her day lying in her cot rolling back and forth but she couldn't roll all the way over.'

The carer, who had fostered 36 children in the past, said rolling over was 'something babies learn to do when they are four months old, not 19 months old.'

The child has been in foster care since leaving hospital.

The parents, now aged 32 and 35, pleaded guilty in November to failing to provide for their child. Each says their inaction was reckless rather than intentional.

The father was described in court as an educated man and the mother had previously worked in child care for years.

Neither parent gave evidence at their sentencing hearing this week but Sydney's Downing Centre District Court heard some of what went wrong.

Through their lawyers the parents conceded their daughter was malnourished but said she had otherwise been in good health. 

The mother claims she was suffering from depression after the girl's birth; the father says his partner was the girl's primary carer.

The mother told a hospital dietitian her entire family followed a vegan diet. She said her daughter would generally have one cup of oats with rice milk and half a banana in the morning

The court heard the mother decided on a plant-based diet for her third child about the time of its conception, which came shortly after she had suffered a miscarriage. 

Forensic psychiatrist Stephen Allnutt noted the couple's first child had been vaccinated to 18 months, the second to six months and the daughter not at all.

The mother displayed a 'constellation of depressive behaviours' consistent with a diagnosis of chronic major depressive disorder. 

The toddler (pictured after she was taken into care) was so malnourished by her parents she looked like she lived in the Third World

She had difficulty focusing, took a long time to choose a school for her boys and had not named her daughter for two weeks.

The court heard the mother would lie awake at night wondering whether she was 'useless' and worrying her partner was cheating on her with a woman at work.

She rarely left their house, even to shop for groceries, and would sometimes spend all day at home in pyjamas. She lost interest in her physical appearance.

Consultant psychiatrist Yvonne Skinner, who interviewed the mother, found she was not suffering from any psychiatric disorder.

There had been tensions in the couple's relationship but the mother had been happy after giving birth to her third child.

'She said that she felt great joy at the time [the girl] was born and she said she was able to maintain good relationships with the children,' Dr Skinner told the court.

Barrister Frank Coyne, for the father, said his client was in fact a meat-eater and the case should not be a 'vegan and anti-vax witch-hunt.'

'This is a truly tragic set of circumstances… tragic for the whole family,' he said.

Mr Coyne said the mother was the girl's primary carer and spent most of her time with her, while the father looked after the boys. 

The mother and father are pictured hugging leaving court last year before pleading guilty to causing serious injury to their toddler after feeding her an extremely restrictive vegan diet

'He should have noticed, he should have made further inquiries, he should have ensured [the girl] was further seen by doctors,' Mr Coyne said.

The father was the family's sole provider and had tried to support his partner but there had been a breakdown in communication between the pair.

Mr Coyne said the mother dictated the girl's diet and made decisions about vaccination, while the father took a lesser role in parenting.

'He can't be seen as the principal offender,' he said.

The girl had never been ill until the seizure that put her in hospital, when malnutrition was quickly detected and it was found she was also suffering an upper respiratory infection.

'In the time before she went to hospital she had the appearance of good health,' Mr Coyne said. 'In his mind she was someone who was happy, engaged and bright.

Judge Sarah Huggett Failed noted the girl had put on only 2kg in 18 months and could not walk or talk. She did not accept the father could not have known something was wrong.

'He must have realised at 18 months that she wasn't reaching the milestones she should have,' Judge Huggett said.

'He did nothing... He could have picked that child up and driven her to a doctor.'

Barrister Ben Clark, for the mother, said the case was tragic and had 'massive consequences' for everyone involved.

'At first glance people are going to say, 'What sort of mother is she?'' Mr Clark said.

'The mother let her down and let her down terribly.

'This is a very, very serious matter. I don't try to shape it any other way.'

The father is currently allowed a supervised visit with his three children once a fortnight. The mother, who lives in a different state, gets to talk to them on the telephone every two weeks

Mr Clark also said that while the child was malnourished, 'in all other ways it appears she was being cared for properly.'

Depression could explain why the mother did not get the girl immunised or get any post-natal tests done.

'There is no evidence she's some kind of anti-vax crackpot who should be living in Byron Bay,' Mr Clark told the court.

As soon as the child became ill the mother had called an ambulance. 'When the chips were really down, that's what happened,' Mr Clark said.

'The cost to the child is enormous. The cost to [the mother] is enormous as well.'

The father is currently allowed a supervised visit with the three children once a fortnight for which he has to drive two hours each way. 

The mother, who lives in a different state, gets to talk to them on the telephone every two weeks. 

The girl, now almost three, has delayed motor skills, developmental delays, and due to her height being out of proportion with her weight is considered obese.

She now lives with a relative and her two brothers in another state.

As noted by her former carer, the girl obviously cannot speak for herself of the horrors she suffered in her parents' custody.

'As [the child] was a baby during the time she was neglected she can't tell us about her experience,' the carer told the court.

'But as her carer I can share what I observed in her physical appearance and her behaviour that were the effects of her neglected experience.

'As adults we can understand that a baby is completely helpless and reliant on their parents to provide care for them and that [the child] was defenceless and unable to protect herself from her parent's inadequate care of her.' 

 The couple will be sentenced in June.