A mentally ill woman who mistakenly thought her daughter was a dwarf has been put on a good behaviour bond after leaving the baby to drown in a bathtub.

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When she rang triple zero to say the baby was underwater, the woman was repeatedly asked - in a conversation lasting almost 11 minutes - to go into the bathroom and help but kept saying: "I can't go in there."

The now 41-year-old woman, who can't be named for legal reasons, pleaded guilty to the manslaughter of her six-month old daughter at their Sydney home in November 2010.

The plea was based on the partial defence of substantial impairment due to an abnormality of the mind.

Noting the baby's "life was ended before she had a chance to live any of it", Justice Robert Beech-Jones said no victim impact statement from anyone associated with the baby was presented to the court.

There could be many reasons for this, he said, but "the absence of anyone to speak to this court demonstrates (the baby's) vulnerability".

In the NSW Supreme Court on Friday, Justice Beech-Jones placed the woman on a four-year good behaviour bond with conditions, including that she continues to undergo psychiatric treatment.

He noted she had already spent about two years in custody and been admitted to various psychiatric institutions.

"I have no doubt the consequences of her actions will remain with her for the rest of her life," he said.

He was not satisfied she was remorseful, but this did not mean she was callous about her crime, and to return her to custody would likely cause her "considerable psychological harm".

The woman had become obsessed with the mistaken belief her baby had dwarfism, repeatedly asking for genetic testing and inquiring whether plastic surgery could be performed to remove skin tags near the infant's ears.

One hot day, she went to a birthday party with the baby dressed in a thick knitted jumpsuit with a hood to hide the skin tags.

"Every time I look at her I think she's a dwarf," she told medical staff who kept on assuring her the baby was healthy.

"It's affecting my bonding with her and everyone in the family, including my husband, thinks I'm crazy".

She told the triple zero operator the baby had fallen off a seat into the water when she went to get shampoo and was face-down in the water.

One psychiatrist said the woman had been showing early symptoms of schizophrenia, while another said her concerns about her daughter's health were "delusional".

AAP

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