I have been wondering the same things that Joan Ellen Armstrong has. As
a LLLL, it is no problem getting  hours handling phone calls and leading
meetings. But how does one obtain practice doing things such as breast
assessments, suck assessments, and handling the more challenging cases
that LLLL's generally don't deal with , or if we do, we usually end up
referring to an LC?(cases such as FTT, relactation, etc.)How to get
experience helping a mom use an SNS? How do I myself learn about how to
operate one of these?What about pumps- I have some personal experience
pumping, due to hospitalizations of my own newborn sons(one almost died
from viral pneumonia, the other had surgery for congenital defect of sm.
intestine).But there are so many pumps out there, and I personally
didn't use all of them!

As a LLL, I have never done a home visit, and my understanding is that
these are generally not all that commonly called for anyway.

How am I to get experience assessing someone's nipples to see if they
are inverted, etc. I have read a lot, I've looked at pictures, but I'm
sure nothing can take the place of seeing the real thing!

Do any practicing LC's take on "apprentices", as do some lay midwifes,
so that you can learn from watching a pro, and helping out, until you
gradually can start doing the stuff yourself?
I can do a lot of "book learning", and attending conferences and
workshops, and counseling moms, but how do I get true clinical
experience? ( I am not an RN or any other type of HCP).

One thing that sounds good to me is something at the Georgetown U.
Lactation Center- think that as part of your weeklong program, you do
observe LC's in action, which is great, but it's not really enough !

Thanks,,
Ellen Vegh, LLLL in Pittsburgh