Susan Elizabeth MacDonnell pleaded guilty in November 2011 to aggravated assault and failing to provide the necessities of life. (CBC)

The Dartmouth woman who admitted to starving her infant foster daughter to the point where the girl almost died spoke for the first time publicly and apologized during her sentencing hearing.

Susan Elizabeth MacDonnell, who pleaded guilty in November 2011 to aggravated assault and failing to provide the necessities of life, addressed the courtroom in Halifax on Tuesday.

"The horror that I feel at the thought of any child being hurt, let alone one that was mine, has to live side by side with what I know that I did," MacDonnell said.

She told the court, "I was a broken woman."

The toddler, who was called Rachel at the time, was 22 months old when she was living with MacDonnell in February 2010 and hospitalized at the IWK Health Centre for dehydration and malnutrition.

Staff at the IWK Health Centre then suspected further abuse when the toddler was slow to recover while hospitalized.

MacDonnell later admitted to disconnecting the child's feeding tube in the hospital — which doctors were using to try to deal with the child's puzzling inability to gain weight — and to diluting a high glucose formula at least six times.

"Apologies cannot be made to Rachel personally," MacDonnell said in court Tuesday.

"I can only make them to the court, and I do so."

The girl, now four years old, has been adopted by another family and is said to be doing well. Other foster children in MacDonnell's household have since been removed by the provincial Department of Community Services.

'I'm forging into virgin territory'

MacDonnell's sentencing hearing was originally scheduled to take place last May, but was delayed when Nova Scotia Supreme Court Justice Kevin Coady ordered another psychiatric assessment for the accused.

Dr. Grainne Neilson, the forensic psychiatrist who examined MacDonnell, presented her report earlier this week and said MacDonnell is a "perpetrator of child abuse" suffering from "factitious disorder by proxy."

Neilson said she believes MacDonnell also has a borderline personality disorder and is a pathological liar.

Coady voiced concerns about Neilson and her report on Tuesday.

"Her report is clearly pro-Crown," he said.

"I thought that Dr. Neilson stepped over the line when she very clearly said your client was a pathological liar," Coady said to defence lawyer Jean Morris.

The Crown is asking for a five-year-sentence, plus a DNA order and a two-year weapons ban. The defence has requested a two-year sentence plus probation.

Coady's comments suggest he is still wrestling with this sentence.

"I really feel like I'm forging into virgin territory," he said.

"I've always thought that female offenders who end up in Truro are in a much more therapeutic environment than male offenders who end up in Springhill or Renous."

Coady is set to hand down his sentence Friday.