In what could be a tragic case of child abuse, police have officially charged a New York state mother with deliberately and fatally poisoning her young child in order to garner sympathy and attention online.

For various reasons, ranging from ear infections and high fevers to mysterious spikes in sodium levels, five-year-old Garnett Spears was in and out of hospitals ever since he was born. Although doctors were generally at a loss as to why – the boy also had trouble gaining weight and, as a result, had a feeding tube put in place – police now believe they know what was behind at least some of the problems: his mother.

After an investigation that began even before Garnett’s death on January 23, New York police have accused mother Lacey Spears of purposely poisoning her son with too much salt. The 26-year-old Spears has been charged with second-degree depraved murder and first-degree manslaughter, charges to which she pleaded not guilty on Tuesday.

"This mother was intentionally feeding her son salt in toxic levels," said Assistant District Attorney Doreen Lloyd in court, according to the Journal News.

Due back in court on July 2, Spears is being held at Westchester County jail without bail. If convicted, she could face up to 20 years or life in prison. Court documents stated that when one detective said the cause of Garnett’s death may never be known, "Lacey Spears smiled and appeared to be relieved somewhat.”

Photo: Lacey Spears surrenders today at #Westchester County Police HQ, Hawthorne. (Frank Becerra Jr/The Journal News) pic.twitter.com/ierMVWWYH6 — LoHud Rockland (@InsideRockland) June 17, 2014

Officials also believe Spears suffers from a psychiatric illness known as Munchausen by proxy, which involves a parent deliberately harming or making their child sick in order to get attention. In addition to gaining sympathy from those around her, Spears regularly blogged about Garnett’s worsening condition, posted updates regarding her son on Facebook and Twitter.

Although law enforcement picked up the case in the days before the young child’s death, the investigation did not heat up until January 19, when doctors at Maria Fareri Children’s Hospital notified police about Garnett’s questionably high sodium levels. In a separate report, the Journal News reported that Spears told police Garnett had been hospitalized at least twice since January 14, and investigators believe these medical visits were the result of her using his feeding tube to supply the boy large amounts of salt.

The Journal News also interviewed witnesses at Maria Fareri who said they watched a doctor challenge Spears about the nature of Garnett’s condition. The doctor reportedly told Spears it was "metabolically impossible" for her son's body to naturally produce sodium levels as high as he was experiencing, and that "something isn't right."

Spears was able to remain with Garnett at the hospital unmonitored, but she was told by police not to leave. The next day, friends visited and recalled the boy begging them not to leave. On January 21, Garnett went into cardiac arrest and was declared dead two days later.

"Her behavior was just weird in the hospital," one friend told the Journal. "It was not the behavior of a grieving mother. She was more concerned about what everyone else was saying, or what investigators were asking people, or what people were saying on Facebook, than putting all that aside and taking care of her child."

In an interview with police, Spears suggested that if she poisoned her son, it was not on purpose because she was mixing prescribed medication into his feeding tube. She also said "Garnett would once in a while play with the syringe used for the GI (tube) feedings and it's possible he could have put something in the GI feeding tube."

Prosecutors however, claim they have obtained computer and internet records that reveal Spears searched specifically for the potential effects of salt on her child. Meanwhile, a neighbor recalled that when Garnett was dying, Spears called and asked her to get rid of the bag used to feed the boy through his tube. Police were eventually able to seize this bag, and discovered very high levels of sodium in it.

According to CBS New York, Spears turned herself in when police obtained an arrest warrant and delivered an indictment against her.

“She really didn’t show any emotion,” Westchester Police Capt. Christopher Calabrese said to CBS. “She was kind of stoic when she came here. I think that she knew the grand jury was going on. She anticipated this happening, and she turned herself in with her attorney.”