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