While I agree that visual examination of breasts, visual observation of a feeding, and visual & physical exam of infant are optimal, as a LLLL for 19 years, I have to say that it is amazing what you can deduct from a phone conversation. Thousands of LLLL's have helped thousands of mothers with phone contact only. If the situation dosen't resolve within a quick time frame, then obviously, a next step is indicated. Most LLLL's will refer a mom to an LC at this point if the LLLL is unable to help the mom in person. LLLI has an excellent resource that might help those who are needing some help in forming questions, deciphering the answers, etc, includes descriptions of many different nipple, sucking problems, is indexed for easier reference and is under $10. It is An Overview of Solutions to Breastfeeding and Sucking Problems by Susan Meintz Maher. It is publication # 67. Kathe Catone, IBCLC, LLLL