I have a difficult time with determining the causes of sore nipples over =
the phone and avoid using a blanket positioning statement since there =
are so many factors  involved besides mom and baby's =
position:suck(disorganized,uncoordinated or coordinated,frenulum plus =
all those "common" interventions used during labor/delivery and their =
influence on babe and mom,and infant maturity and so on,not to mention =
the normal changes that occur to the skin of the nipple with ongoing =
breastfeeding.I prefer to see mom in person....positioning is easier in =
person as well.(When there's thrush in babes' mouth and diaper area and =
mom has sore,cracked nipple and/or venospasm I have felt comfortable =
with the determination of cross-infection  and this was from a mom =
calling 45 miles away,and her 5th babe to be breastfed---she was so =
amazed that she was having problems after nursing 4 others without a =
gliche.I've heard this same comment from a co-worker when she got thrush =
nipples from her 5th.
Denise Ferrell,IBCLC