USAmma, thanks for posting your photos, I had no idea I had flat nipples until way too late - despite having done an antenatal breastfeeding course and consulting an LC before DD was born to make sure I had done everything I could to be prepared.
I have been stewing over this for days and not saying anything because I know your intentions are the best DaryLLL, but i have decided I really should speak up. As a woman who went through flat nipple hell to breastfeed there are few comments I find as trite or offensive as "babies don't nipple feed, they breastfeed". A couple of the many LCs I saw came out with this jem at the time and I a) had an overwhelming urge to slap them b) didn't revisit them. My whole breast(s) suffered, but it was my nipples that were the root of my problems.
My history in brief: I had grazes, bruises, then cracks, then gaping holes, blocked ducts, engorgement, 4 bouts of masitis in 3 months, cellulitis requiring antibiotics for only the second time in my life, vaso spasm, was unable to leave the house for about 6 weeks because I couldn't wear clothes (not just no bras, no tops, no nothing), etc... I think the only problems I didn't have were low supply and thrush. For a few days I had to do every feed on my hands and knees hanging over DD while DH held my breast in her mouth because gravity was the only thing that would get the milk out, unfortnately we never got any video of this, it was pretty funny... Around 8 weeks it started getting a bit easier, by 3 months I could feed in public (because I didn't need to cry through feeds anymore). Around 4 months it was just unpleasant most of the time not painful, and I guess it was about 6 months I just stopped noticing any sensation at all. DD is now 11 months and still exclusively breastfeed, two weeks ago another mum (of a 3 month old) said to me "after we left your place the other day my husband said to me 'you make feeding look easy, but she makes it look like nothing at all'", It made me realise just how far I have come.
I have met a number of women who have kept breastfeeding through similar levels of difficulty to me, one who had worse problems than me and fought for 6 months before giving up and far far more who give up for what seem to me to be pretty pathetic reasons ("Oh I had to give up at 2 weeks because I had cracked nipples"). But all the women I have spoken to with serious flat nipple issues have had similar stories, the advice they got was unrealistic at best and crappy at worst. The worst advice I got was from the best LC in my town, the one that trained all the others, that they go to themselves. The best advice I got was from my GP (who is a certified LC herself, and visited the other LC herself twice), her advice being "you are doing everything right, nothing is going to make this better but time, you just have to keep going, you will turn a corner by about 8 weeks". She was also the only one to make the very interesting observation that in her experience it is the women with really flat nipples that also have really fiborous nipples which WILL NOT be drawn out, this was certainly the case for me and you know what, after 11 months of breastfeeding my breasts are actually a fairly typical breast shape for the first time in my life. Before breastfeeding they were more like downward pointing cones with a very strong mind of their own. I feel very lucky that the pain stopped for me, I know a woman who is nursing her second child and after a total of 2 years breastfeeding (1 year each) every feed still hurts, and yes they are latched on properly. the advice that it won't hurt if they are latched on properly just doesn't seem to hold true for women with nipples like mine (or worse) and the idea that with a good latch it won't hurt even if your nipples are cracked is just plain stupid. If your nipples hurt when nothing is touching them they are going to hurt when your baby sucks on them, no matter how good the latch is.
I am sorry this is all over the shop, its late. I guess I just really wanted to stress that I feel you should think about how you talk to women dealing with flat nipple problems. OF COURSE make sure they are getting enough breast in the babes mouth, OF COURSE make sure they latch is the best it can be. But don't say things like "babies don't nipple feed, they breastfeed" and don't assume it won't hurt once the latch is right. The LCs that insisted that it wouldn't hurt if I had a good latch, then watched and said "perfect" and then looked puzzled when I wept in pain just made me feel bad and that I was doing something wrong. I am very thankful for my GP insisting I was doing everything right (and she spent hours, over weeks determining this, not minutes) but was just damn unlucky and would have to grin and bear it until things got better, her respect and honesty got me through. Sometimes the best help is acknowledging that only time will fix the problem and that getting through until then will be HARD work.
Oh and DD was checked for high arched palate, tounge tie, etc in her first days of life, these were not contributing factors.