FORT LAUDERDALE, Fla. (AP) — A mother, grandfather, adult brother and two caregivers in Florida have been charged with the starvation death of a 7-year-old disabled boy who weighed 7 pounds (3.1 kilograms) and had bones poking through his skin when he was found dead on Christmas, officials announced Wednesday.

Deonte Atwell had spina bifida, a birth defect of the spinal cord, and hydrocephalus, a build up of fluid on the brain. He had both breathing and feeding tubes and required around-the-clock medical care, which Broward County prosecutors say he wasn’t receiving.

According to police and prosecutors, Fort Lauderdale officers and paramedics were called to the family home last year on Christmas night and found Deonte. They took him to a hospital, where he was pronounced dead an hour later, but doctors said he had likely been dead for some time.

Police say they found 264 unopened bottles of his feeding formula in the family home.

“It’s sad to say that Deonte had suffered all the way through his death,” Detective Jacqueline Sanchez told reporters, adding that his pain was caused “by the people who were supposed to be caring for him the most.”

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After an eight-month investigation, the five were arrested Tuesday.

Deonte’s 37-year-old mother, Michelle Doe, his 21-year-old brother, Tyreck Irvin, and his 33-year-old caregiver, Cassandre Lassegue, are charged with first-degree murder, manslaughter and child neglect. Doe and Irvin are also charged with neglecting two other children, ages 9 and 16.

Grandfather James Graham, 70, is charged with aggravated manslaughter, child neglect and failure to report child abuse.

Mirlande Moltimer, the 47-year-old owner of the service that employed Lassegue, is charged with third-degree murder, aggravated manslaughter and child neglect. Both she and Lassegue also have been charged with Medicaid fraud.

A judge on Wednesday ordered Irvin, Lassegue, and Mortimer all held without bond. Graham is being held on $22,000 bond. Doe is jailed and her court appearance has been postponed until Thursday.

Court records did not indicate if the five have attorneys. The Broward County Public Defender’s Office did not immediately respond to an email seeking comment.

The Florida Department of Children and Families said it is checking its records to see if its agents ever had contact with the family.