For new mothers in a new country, welcome help

Daysi Lemus was constantly exhausted but too afraid to sleep.

She worried that her newborn would pull the blanket over his head and suffocate. She worried because he wasn't eating. Breast-feeding wasn't working. And the baby cried. A lot.

At 21, Lemus was a new mother and a newcomer -- a recent immigrant from El Salvador living in Chelsea with her husband, four brothers, and her father. She didn't know any other moms to turn to for advice, much less one who spoke Spanish.

''She was like a walking ghost," said Ricarda Romao, a specially trained ''Visiting Mom" from the MGH Chelsea HealthCare Center.

Romao, an immigrant from Brazil with three children of her own, a background in medical interpreting, and fluency in Spanish and Portuguese, was assigned to assist Lemus shortly after she gave birth to Jairo, who weighed just 4.5 pounds, last summer. Lemus, who was battling postpartum depression, at first wouldn't even open the door when Romao stopped by. But slowly, Romao won her trust and began visiting twice a week, explaining complicated medical forms and procedures, teaching Lemus how to breast-feed, and sometimes just talking girl talk.

Chelsea has long been the first home for many of Greater Boston's newly arriving immigrants. With the diversity and number of immigrants increasing, MGH Chelsea launched its Visiting Moms program in 2002 to help new mothers overcome language, cultural, and social barriers.

Today the unusual program has a waiting list. And a soon-to-be released study indicates that the Visiting Moms -- with members who speak Spanish, Portuguese, Somali, Arabic, and Swahili -- are making a measurable difference.

''These cultural brokers really helped initiate these women into life in the United States on many different levels," said Ruth Paris, a Boston University social work researcher who is wrapping up a three-year review of the program.

Paris interviewed and tracked the progress of 100 women enrolled in the service and found that depression and stress levels declined for many. Paris said the new mothers, most suffering from severe postpartum depression or other mental health problems, were thankful for help that transcended translation services. The program, funded by Massachusetts General Hospital and Partners HealthCare, is offered free to new mothers, who are usually referred by their doctors.

''It's really negotiating the system with them, helping them learn how to advocate for their child, and listening to them about their struggles being so far away from their families and friends," Paris said.

While Visiting Moms programs are not new -- the Waltham-based Jewish Family & Children's Service has run one in Greater Boston for 17 years -- Chelsea HealthCare's setup is unique, according to Paris. The BU researcher said it is the only one she has reviewed in the state that is based at a medical facility, which provides the Visiting Moms with ready access to special training and to health experts when they need extra guidance. Sometimes they bring a pediatrician or social worker along on a home visit.

''These are paraprofessionals that have walked the walk themselves but also are supervised by other professionals who can help them when the going gets difficult," Paris said.

And the going has gotten difficult.

MGH Chelsea HealthCare Center records indicate that 19 percent of its cases have involved family violence and 37 percent dealt with ''emotional abuse from a partner." But the help provided by Visiting Moms has encompassed a wide range of services, from securing a crib or baby clothes to teaching a new mother how to interact and play with her baby, which can provide critical stimulation for the infant's brain development.

Often the work involves diplomacy. Some Latin American women, for instance, place choker-style necklaces on newborns to ward off illnesses or evil spirits, said Romao. She has suggested a bracelet to lessen the choking hazard. Another common Latina practice is feeding colicky babies tea to help them sleep. Romao has gently coaxed them to breast-feed instead.

''They have a small bottle specific for tea -- they actually buy it at the Spanish store," Romao said. ''They have a lot of practices they bring with them, and we have to respect that."

Facing motherhood for the first time in any culture isn't easy. Peggy Kaufman, who founded the Visiting Moms program at the Jewish Family organization in Waltham, said she was inspired to start the service after she moved to the area, got pregnant, and felt isolated. And she wasn't an immigrant.

Today her program ''runs the gamut," she said, with clients throughout Greater Boston ranging from professional women to stay-at-home moms to women living in shelters. Most have postpartum depression. Few are immigrants.

''Our connections to our extended networks of family care, that has greatly changed in the past 30 years," Kaufman said. ''So much transiency in the workplace, people moving for different jobs. We see a predominance of people living far from family."

Back in Chelsea, Romao recently showed Lemus how to ''childproof" her apartment -- to block off electrical outlets, stairs, and other hazards from her once-frail infant, who has blossomed into a curious youngster with a healthy appetite and a penchant for putting all sorts of things in his mouth.

And his mother, who wouldn't open her door when Romao first visited 10 months ago, has emerged from her cocoon of depression and become a sort of role model in her community.

''In the beginning, she was shy to breast-feed," Romao said. ''Now she goes to church and talks to people about breast-feeding."

Kay Lazar can be reached at klazar@globe.com.