The cockroaches gnawed away 3-month-old Nathan Adam Burk's hair and skin, but malnourishment and dehydration are what killed him.
Two people responsible for his care - his mother and grandmother - were sentenced to prison this week in Oklahoma County District Court.
Two years ago, his grandfather, Estel Ray Sexton, 48, hanged himself in jail, a week after he was charged with the Aug. 24, 1999, starving death of the infant.
"This baby looks like babies from starving countries," District Judge Susan Caswell said Friday as she sentenced the grandmother, Catherine Elaine Sexton, 44, to 30 years in prison for child neglect.
"You had a duty to that grandchild. You didn't seem to be concerned about your duty.
"I find it appalling how you lived. I find it appalling that you ate and drank and did not feed that child. You didn't do it once or twice; you did it every day.
"You could have done something, and you did nothing."
On Monday, the baby's mother, Angela Burk, 23, pleaded guilty to first-degree murder and child neglect for Nathan's death and the neglect of her 23-month-old son, Zachary.
The judge sentenced Burk to life in prison plus 35 additional years for her guilty pleas to first-degree murder and child neglect.
As part of a plea agreement with the district attorney, prosecutors dismissed the bill of particulars asking for the death penalty.
Assistant District Attorneys Lou Keel and Joel-lyn McCormick didn't have an agreement on the length of Sexton's sentence, but they asked the judge for at least 25 years. Sexton didn't want to go to prison so she could go to Arkansas and take care of her dying mother.