A starved and mummified boy was found dead in his cot cuddling a teddy, a jury heard today.
Hamzah Khan's severely malnourished and skeletal remains were only discovered almost two years after he died in squalor at his mother's filthy, rubbish-filled, home Bradford Crown Court heard.
The four-and-a-half year old's body had mummified after he was allowed to starve to death by his mother, Amanda Hutton, 43, from Bradford, who denies the manslaughter of her son.
Dr Matthew Lyall, a Home Office pathologist called to the scene, told the jury grim details of his inspection of the state of the youngster as Hutton watched the proceedings from the dock dressed in a black top, cardigan and skirt.
"He was positioned beneath the duvet," he said. "He was lying supine, on his back, accompanied by a toy, a soft toy, which his right arm was encircling," Dr Lyall said.
Hamzah Khan's body was still dressed in a baby-gro, intended for a baby aged six to nine months, when police made the discovery in September 2011, but he had died 21 months earlier, on December 15 2009, with his body unmoved from the cot.
Dr Lyall said the boy was mummified, the body having decomposed in dry conditions, with the skin leathery and tight and limbs rigid.
He agreed there was an "abundant" amount of insects and flies.
The child's body weighed 1,950 grammes (4lb 5oz), his collar bone and ribs visible beneath the skin, and on his duvet were maggots, pupae cases and insects with flea eggs on the child's hands and head.
Dr Lyall said he inspected the child's body and took X-rays, which showed there were no injuries or fractures to bones and no obvious signs of injury or trauma on the boy.
He then conducted a post mortem but was unable to make any proper study of Hamza's organs as they had all but perished and no immediate medical assessment could be made of his cause of death.
Further expert analysis of the body was sought with the help of an expert in environmental radio-activity, an oral pathologist, a forensic anthropologist and a paediatric dietician.
The youngster was found to be suffering from osteoporosis, or brittle bone disease, due to a lack of calcium through malnutrition, according to expert reports.
Hair and bone tissue was also assessed and analysis showed low concentrations of major elements suggesting the child had been "protein deficient" for up to two years before his death.
The jury heard tests showed the boy was also deficient, and had been for a "substantial period" before he died, in elements commonly found in a range of foods such as cereals, meat, fish and offal.
Tests on his teeth also suggested malnutrition and further examination of his bones showed arrested development and evidence of 'stop-start' growth - where the bones had at some points stopped growing.
The jury heard the boy's bones were more like that of a child aged between 12 and 18 months and this showed "extreme stunting of growth."
Dr Lyall said medical records showed Hamza was born weighing 5.4 pounds and left hospital "fit and well" with no sign of any abnormalities.
But he was only registered with a GP 15 months later and was never actually taken to the doctor's clinic so there were no further medical records on the boy.
Dr Lyall told the jury in his assessment, the boy was suffering malnutrition at the time of his death and this could have contributed, "wholly or in part to his death."
He concluded whatever the cause of the malnutrition he would, "expect a competent parent to recognise severe growth retardation evident in this young child and seek medical assistance."
Dr Lyall said partly because the body was so decomposed no "defining cause of death" could be found - but he said it was important to also look at circumstantial evidence.
Earlier the court heard Hutton did nothing to alert the emergency services about her son's plight and even ordered pizza within hours of his death, Paul Greaney QC, prosecuting, told the court.
Hamzah's body was found in September 2011 after police community support officer Jodie Worsley went to the house on a number of occasions due to concerns raised by neighbours.
The court heard how there was terrible smell coming from the terraced house and, when Hutton eventually opened the door, there were flies buzzing around her.
Police went into the property and ''what they discovered disturbed even hardened officers,'' Mr Greaney said.
The prosecutor said Hutton was an abuser of alcohol and cannabis and had been subjected to violence by Hamzah's father, Aftab Khan, who lived away from the home.
In police interviews Hutton said her son had become particularly unwell on December 14, 2009 and died the next day.
She told police that things deteriorated after her son's death and she began to drink a bottle of vodka a day.
Her house contained a huge amount of rubbish, rotting matter, faeces and empty bottles and smell "almost beyond description," the jury have heard.
The prosecution say Hutton was guilty of manslaughter by gross negligence on two grounds - that she failed to feed him adequately and failed to seek medical assistance for him.
Jurors were told they will hear further medical evidence tomorrow before Hutton takes to the witness box in her own defence on Monday.
The trial was adjourned later today.