Regarding reporting suspected child neglect/abuse:  be VERY SURE that the
situation is one of true neglect, and that resources involved in the case
aren't meeting her needs.  Hotlining someone, depending on the state located,
and the worker who gets involved, can be very helpful, but can also create a
bigger nightmare.  Many times, mom and baby are separated, pending results of
the investigation.  This would pretty much preclude any potential for this
mom to continue bf.  I agree with a previous writer who mentioned postpartum
depression (PPD) as a possible cause for the situation.  PPD is an insidious
disorder, may not be manifested by weepiness, lethargy in mom, and other
classic signs of depression.  The inconsistent behaviors, denial that there
is a problem, and avoidance of medical help are all seen in PPD, however.
 Check for local support groups or psychiatrists/psychologist specializing in
PPD.

If you can establish trust with this woman and her husband (who may also be
unaware of just how dysfunctional his wife is), as other writers have
suggested, and coordinate efforts with other professionals involved in her
case, she might have a better chance at recovery than if you turn her over to
welfare authorities, whose primary concern is to get baby out of the
potential danger.  Of course, if it's not possible to provide the support
needed, and the baby's health is deteriorating, a hot line call will mobilize
forces rapidly, to save baby's life.

Carol (speaking as social worker, as well as nurse, LC, and mother--and
married to a child abuse family therapist!!)