"My sweet little prince", is how Lacey Spears affectionately referred to her five-year-old son Garnett-Paul on her Twitter account. "As a parent we want to protect our child from anything that could harm or hurt them", she wrote on her blog.
However, the boy did not live to see his sixth birthday on December 3 – and his death gave birth to a heartbreaking murder case.
His mother stands accused of poisoning him with salt, while chronicling his worsening medical condition on social media.
Mom denies claims
Twenty-seven-year-old Spears, who is now on trial in New York on charges of depraved murder and manslaughter, could be imprisoned for 25 years to life. She denies killing her son.
The single mom, who was sharing her son's hospital room, allegedly fed him salt through a hospital tube while he was at the Westchester Medical Centre in New York last year, reported Associated Press.
This is believed to have triggered a rise in his sodium levels that led to seizures, brain swelling and eventually Garnett-Paul's death.
Why too much salt is dangerous
Health24 resident doctor Heidi van Deventer confirmed that too much salt is very dangerous and can indeed cause death. "Usually, too much salt (sodium) is caused by too little fluid in the body (dehydration) and not by excessive amounts of salt in the body."
She said the medical term referred to this is hypernatraemia.
"The mechanism to counteract a high sodium level is thirst. So somehow the mother likely gave him fluids with high sodium content and restricted his fluid intake."
Van Deventer said the fluids would most likely have been intravenous or through a nasogastric tube, because drinking fluids with a high sodium content would make one vomit immediately.
What the prosecutors think
This is the view of prosecutors too who believe that Spears administered salt through a feeding tube into her son's stomach. "This mother was intentionally feeding her child salt at toxic levels," said prosecutor Doreen Lloyd, according to AP.
Acting state Supreme Court Justice Robert Neary said that jurors are likely to hear that Spears researched on her iPhone the dangers of sodium in children and the properties of iodized salt. Bederow, who is also a former prosecutor, told the news website that this alleged request is "powerful consciousness of guilt evidence".
Mark Bederow, a New York-based criminal defence attorney, told FoxNews.com that this provides strong evidence that Spears knew what could happen to her son.
Other evidence includes bags with high concentrations of sodium that were found. FoxNews.com reported that a source claims that Spears allegedly asked a friend to destroy feeding tubes within her home.
Read: Social Media can be a main cause of Munchausen by proxy
What the underlying problem could be
Van Deventer told Health24 that the mother may have been suffering from Munchausen syndrome by proxy. "This is when a parent or caregiver fabricates or creates illness in his/her child to draw attention to them. It seems as if this could have been the case."
However, AP reported that prosecutors indicated that they had no intention of bringing up Munchausen after Spears' lawyers asked the judge to prohibit any mention of it.
Read in the expert forum: This mother is overmedicating her children
Concern over medical negligence
Carin Smith, a clinical metal toxicologist, said although the burden of murder is laid at the mother's door, the incident also makes one question the clinic's risk of medical negligence.
"The risk involved in correcting hypernatremia, is that the brain quickly adapts to the high tissue levels of salt and if one corrects with free water, the brain will swell and seizures and death might be the result of such overly rapid correction."
She said if a proper work-up had been done, Garnett-Paul's death could have been prevented. "If tests were run, showing that the boy had hypernatremia, it should have been a warning sign."
The most common cases of hypernatremia have been documented where babies or children were deliberately poisoned by parents, said Smith.In this image from MySpace. Here Garnett-Paul is pictured with his mom at work.
When Garnett-Paul passed on, Spears tweeted: "Garnett the great journeyed onward today at 10:20 am", according to AP.
Read: Munchausen vs Munchausen by proxy
Here are some social media posts from accounts with the name Lacy Spears:
These are some tweets:
This picture is from Spears' blog entitled "Garnett's Journey".
This image from MySpace is captioned "Mommy, I feel bad and my belly hurts." It is from the album titled "Garnett's Hospital Stay".It seems the album contains pictures from all his hospital visits.
On Pinterest, Lacy Spears has two boards about her son's birthday, but there are no pictures of him on it.
Here is a blog post about Garnett-Paul asking about his father, who is reportedly dead.
No Facebook account was found for Lacey Spears but we did come across a group in support of her:
SA’s rising temperatures raise mental health concerns
Toddler foods loaded with salt and sugar
Sensitivity to salt puts black South Africans at stroke risk
*Health24's CyberShrink will be covering an article on Munchausen syndrome.