The town, which used to thrive on farming and food production from their fertile lands, is now filled with residents reliant on aid groups and the dried foodstuffs they deliver for their survival.
Amid all the horrors of life in Madaya, families are fighting to stay alive. Over recent days, ABC News has been in regular contact with one of them.
While the family can’t leave the town physically, they can tell their story to the world. Through text messages and phone conversations, a heartbreaking picture of unimaginable suffering emerges which is documented on a live blog.
Here is a summary of some of Madaya Mom's most emotional dispatches.
Day 1: Tuesday Jan. 19
Today has been a difficult day for the family. They felt ill for much of the night from severe stomach pains and vomiting. The mom says their stomachs are having trouble digesting food since they've been hungry for so long.
When we spoke to her yesterday, she detailed their adapted eating habits.
"Today our one meal was rice and bean soup... our bodies are no longer used to eating, my children are hungry but are getting sick, severe stomach pains from the food because their bodies aren't able to digest and absorb the food because they were hungry for so long," Madaya Mom wrote.
"When we wake up, we drink mint or thyme tea from the garden -- with a little bit of sugar. It keeps the children from being hungry for a while."
Food is not the only type of fuel that is scant in the area. The city has not had any electricity in the past six months. The family uses their car battery to charge their phone but that is dependent on the level of fuel that they have left.
The family told ABC News that a gallon of fuel cost the equivalent of U.S. $8.64 prior to the siege in July. Now, it costs about U.S. $90 per gallon.
Day 2: Wednesday Jan. 20
DISPATCH ONE: After an 11-hour silence, Madaya Mom finally was back online texting at 2 a.m. Syria time.
She had been so ill on Tuesday, and caring for her equally ill children, she had no energy to even text.
She had gotten a bit of sleep after vomiting the little food -- some rice and beans -- she had eaten because her stomach, and her childrens', were still unable to digest solid foods after being hungry for so long.
She was up so early this morning, attempting to heat her home by burning pieces of wood from her closet, she texted, but was grateful even in this dire situation:
"I’m up now, at 2 a.m. to heat up the house. It snowed yesterday and it’s really cold. So we’re breaking up the closet for firewood. We’ve already used the big dresser. And we’re lucky because we have wood furniture, others don’t," the Madaya Mom wrote.
DISPATCH TWO: Madaya Mom spent another day caring for her sick children, with meager medical supplies.
Her youngest is still suffering from such acute stomach pains. She reluctantly sent his older brother to stand in the day-long line at the health dispensary, the only source of medicine in town. He managed to get the medicine but returned home distressed.
"He came back home very shaken. He told me he saw many people fainting in front him, and kept asking why some of the children were skin and bones, walking barefoot," Madaya Mom said.
She thinks her son might be having a physical response to the hunger and anxiety, but she’s not sure.
"[He] suddenly started having a rash all over his body, and in some places his skin is peeling. I have no cream to soothe the itching, I could only use cold water compresses and hope they relieve him. They helped a bit but not much. I don’t know what’s causing this," she said.
All the pharmacies have closed, according to Madaya Mom. There were 10 before the siege.
"I learned today that the countries could not agree. You cannot imagine how disappointed and depressed that news made us,” she said.
"I truly feel depressed and that the world has abandoned us because we are weak. It’s as if whether we exist or not doesn’t make a difference for the big powers,” she said.
DISPATCH 4: Madaya Mom said that the differences between her life before the siege and after are striking.
She said that she and her husband owned a plot of land outside of the town. Now, they are relying on dried goods from aid agencies and breaking down their furniture for firewood.
"Before the war, my husband was a farmer -- our land was very fertile. We grew all sorts of fruit trees and vegetables, including succulent apples and pears," Madaya Mom said.
"Most of the residents of Madaya work in farming. Our produce is known around Syria for its superior quality and taste," she said.
Day 3: Thursday Jan. 21
Madaya Mom describes her five children as vivacious and very different from one another. They all seem to have enjoyed going to school and been bright students. She says they miss going to school, which was completely suspended a month ago after months of intermittent classes
"Students stopped going because they were so hungry, and so many were passing out. Their teachers and the principal who live on the outskirts of Madaya were barred from entering town so after that happened the townspeople started volunteer-teaching as an act of resistance, but now the school is shut," she said.
One of her daughters loves to write poetry and her favorite subjects are English, physics and Arabic.
Another is the family performer.
"Before the siege, her older siblings would film videos of her singing. Does she have a beautiful voice? Not exceptionally, but she has a presence!" Madaya Mom said.
One of her sons emulates his father and likes to act like a little man with responsibilities, but also has an interest in fashion:
"He loves to take care of his looks. Before the siege he used to buy his favorite cologne with his pocket money! And he had been saving up his allowance to buy a watch he really liked but he didn't get a chance to buy it before the siege started. Now he refuses to spend that money because he says as soon as the siege is lifted he is going to buy that watch!" she said.
Day 4: Friday Jan. 22
Madaya Mom answered a host of questions as part of a Reddit AMA. For highlights from the session, which stretched over two hours, click here.
One particularly emotional story came when she was asked to reflect on what has happened to her and those close to her since the start of the Syrian Civil War almost five years ago:
This topic always brings out tears before words.
Three years ago I lost my father to a tragic accident. Four months and 10 days after that, we lost the one who had become like father to us, my eldest brother. He was killed in a car bomb.
I was pregnant at the time and thought I would miscarry I was so distressed.
Our tears barely dry from one wound and then another wound is inflicted.
This July, my youngest brother was killed. He had taken up arms when the siege was enforced but only in self defense, to protect the people of the town from the armed attacks we've been subjected to. The post he was guarding with his friends was shelled. His friends got hit. After he rescued the first one, when he got back to get his other friend, a sniper shot him dead.
Please check back in for updates on this story.
ABC News' Jon Williams contributed to this report.