A New Mexico mother has been arrested after authorities say she is suspected of allowing her 5-year-old son to slowly die by starvation.

Marecella Vasquez Montelongo, 23, was arrested in late February months after her son, who had Cerebral Palsy and other disabilities, was found in July unconscious and not breathing at her Albuquerque home. The boy was pronounced dead and an autopsy later determined that he died of starvation and dehydration due to neglect, according to a criminal complaint provided to USA TODAY.

In the years prior to the boy's death, state investigators with the Children, Youth, and Families Department had responded to at least four reports of neglect involving the child, according to the complaint.

Montelongo had her first court appearance Wednesday in a Bernalillo County court room on a charge of child abuse resulting in death. A judge ruled that Montelongo must remain in custody until the start of her trial and complete an addiction treatment program, according to KOAT-TV, which was the first to report on the case.

Philadelphia:Body found in duffel bag identified as 4-year-old reported missing in December

Child appeared to be 'skin and bones' at his death

Albuquerque police were dispatched to Montelongo's home on July 16 after receiving a report of the unresponsive child. While paramedics attempted life-saving measures, the boy was pronounced dead at the scene, according to the complaint, dated Feb. 26.

Montelongo told police at the scene that she had fed her son but that he had vomited. Shortly after, she noticed he was not breathing and called 911, the complaint states.

At the time of his death, the boy appeared as "skin and bones," with his hip bones clearly defined and open ulcers on his tailbone, according to the complaint. When medical examiners conducted a preliminary autopsy, they discovered that the boy had dropped to a weight of about 13.6 pounds.

The final autopsy, which was completed in October, concluded that Montelongo's son had died from starvation and dehydration, and ruled that the manner of death was a homicide.

'Red flags' surfaced before boy's July death

The boy was nonverbal, blind, used a wheelchair and required round-the-clock care, according to investigators. Montelongo was required to give her son medication three times a day through a gastrostomy tube, otherwise known as a G-tube.

However, Montelongo routinely missed her son's doctor's appointments, including five since December 2022. While she noticed her son was losing weight, she told investigators that she did not think it was a concern, the complaint states.

Since the boy's birth, the New Mexico Children, Youth and Families Department received four reports of medical neglect, including one report that was substantiated, according to the complaint.

Though the child was enrolled at he New Mexico School for the Blind and Visually Impaired, records provided to investigators showed that he only reported for on day of school in September 2022 and never showed up again.

"This defendant made efforts to hide the abuse and this child's demise from medical advisors and the school," Bernalillo County Judge David Murphy said at Montelongo's hearing, according to video aired by KOAT-TV.

Some advocates went so far as to question how Montelongo was able to retain custody of her son following the series of red flags.

"We had medical providers, educational providers, service providers and family members raising flags," Maralyn Beck, founder and executive director of the nonprofit New Mexico Child Network told KOAT-TV. "Yet here we are."

Eric Lagatta covers breaking and trending news for USA TODAY. Reach him at [email protected]