A case study of genetics consultation requested for a 41 week 5 day gestation female with congenital hypotonia and poor feeding is presented. Topics include considered she had been admitted to the NICU on the second day of life from a community hospital and examines she was born after a routine pregnancy by induced vaginal delivery, with vacuum assist, for post-dates and through clear amniotic fluid to a healthy 35-year old G3P3 mother.