“Does he send down imperfect babies to the world”
Actually, yes. Then we improve upon the boys by giving them a bris milah. And then we teach them right from wrong as they grow older. And we generally try to improve our imperfect selves in the years we have on this earth.
All of us are born imperfect and all of us die imperfect. Our job is to 1. improve ourselves spiritually and 2. keep ourselves physically healthy so we can do #1 as long as possible.
If someone refuses to eat on yom kippur despite medical and/or rabbinic advice telling him to eat, and says that he has bitachon that Hashem will protect him is held responsible if death results. Not sure how this is much different.
Parting shot…
If you want to claim that Hashem would not create imperfect babies, how do you explain the unfortunate incidences of children born with various degenerative or terminal illnesses?