Social workers and medics knew nothing of the plight of a boy found starved and mummified in his cot because his mother failed to co-operate with services, a court heard today.
Hamzah Khan, whose severely malnourished and skeletal remains were only discovered almost two years after he died in squalor at his mother's filthy, rubbish-filled home, had never been seen by a GP after his birth.
And there were no medical records on him from the age of two weeks old until he died aged four and a half, Bradford Crown Court heard.
His body was still dressed in a baby-gro, intended for a baby aged six to nine months, when neighbours called police in September 2011, but he had died 21 months earlier, on December 15 2009, with his body unmoved from the cot.
His mother Amanda Hutton, who drank heavily and suffered domestic violence from her husband Aftab Khan, consistently failed to keep doctors appointments, failed to get him immunised and slammed the door in the face of repeated calls from health visitors, the court heard.
Hutton, 43, from Bradford, denies the manslaughter of her son by gross negligence by allowing him to starve and failing to get medical assistance.
Dr Kathryn Ward, a paediatrician at Airedale NHS Trust in Yorkshire, told the jury medical records showed after Hamzah was born in June 2007, he was only ever seen once by a midwife and once by a social worker, in November 2006, three years before he died, when he appeared "well cared for and well dressed".
"From two weeks of age, we know nothing about this child," Dr Ward told the jury.
"His personal development, behaviour, his personality or general health.
"It's a blank page.
"The picture of non-engagement and failure to respond to professionals from a variety of areas is a matter of great concern."
The court heard police had been repeatedly called to Hutton's home, starting in May 1996, to rows and fights with her husband.
After Hamzah was born, on the small side but otherwise fit and healthy, health visitors repeatedly called but failed to get into the house.
On one occasion the health visitor saw curtains moving inside, but no one answered the door and on another occasion the door was opened but Hutton, wearing just a towel, "was perceived to be hostile, said she was busy and slammed the door".
When Hutton failed to register the child's birth she was visited by the registrar and was seen to have a "puffed up" eye injury and smelt of alcohol.
Dr Ward said "multi-agency" meetings were called about the situation, involving police, council and health authorities.
But by October 2009 after repeated failed appointments, Hutton's GP surgery removed mother and child from the patients list - as is normal practice.
"It's something being addressed locally because it means children sink further beneath the radar," Dr Ward added.
Paul Greaney QC, prosecuting, asked the witness: "Do you have any view on the history of non- engagement by Amanda Hutton?"
Dr Ward said: "The picture is one of gross negligence and non-engagement with professionals.
"We have the history of domestic violence. All of which suggests things were not well, limited contact with the mother suggests she was feeling low since the birth and had taken to using alcohol as a prop.
"The picture provides evidence of neglect of the child's health and emotional needs."
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.
He was only found 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 a 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.
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 has heard.
Dr Ward was asked her opinion of Hamzah's cause of death.
She said it was complicated due to lack of medical records and the length of time after death when the body was found, hampering any useful post mortem.
But she added: "I have no doubt that malnutrition was a significant factor and indeed the root cause of the child's death, though it's not possible to say whether he died primarily of starvation or whether there were other factors such as pneumonia, which often occurs as a final terminal event in a child who dies."