Karen,
Another alternative that is sometimes available is the "preventive services"
agency.  Whenever I have a mom I am concerned about, I contact my local
prevention agency and speak to one of their social workers.  In all cases, the
moms went in for an appointment and were helped before any overt abuse took
place.  This agency has the power to refer a mom to child welfare if
prevention efforts fail. I was able to present this as a free service to
assist moms who are under stress to deal with their feelings.  Non-threatening
that way.
Catherine Watson Genna, IBCLC