Re: Difficult BFing experience - need help!
Welcome to the forum and congratulations on the new baby!
The creased, flattened nipple you describe- that's a very good indicator of a shallow latch. For a lot of people, the "new lipstick" description fits, in terms of shape- there's a ridge across the top, a rounded side, and a flattened side... Did anyone check your baby for a tongue or lip tie? Sometimes that can cause persistent latch issues, and they could match with the "tongue flicking" you're experiencing. But often shallow latch issues are just caused by the baby being small, with a mouth that can't achieve a particularly deep latch even when mom is doing all the tricks- nipple sandwich, asymmetrical latch, etc. This is when you get stuck with the "be tough, be patient" advice; if you are tough enough for long enough your baby will grow out of the problem and you'll be nursing pain-free. The fact that you're not mentioning any cracks or blisters suggests that you'll see improvement sooner rather than later, maybe within the first month or so. (Of course there are no promises- I hate it when people tell moms " Oh, everything gets better by 6 weeks" because for some moms, that's just not true!)
Have you tried nursing in a reclined position? Sometimes that helps, and it's worth a try even if your baby is very picky about positioning. Be patient with him over positions- he will eventually discover other ways of nursing. But with a newborn, often you simply do what works.
Don't worry about your baby needing help to latch. Again, this is probably a problem that is caused by him being very young. Newborn babies are instinctively driven to latch but not that skilled at it. They often thrash, unlatch, bob their heads, etc. you just have to be patient and let the baby learn the skill of latching on. It may help to get to him before he becomes frantic, offering to nurse at his earliest cues or even before he starts giving you cues. If he does get frantic, try offering him your pinky finger to suck (nail held down towards the resilient tongue rather than directed up towards the delicate palate). A few seconds of sucking on a pinky may calm him enough for a repeat latch attempt. Expressing some milk onto the skin of the nipple before latching the baby on may also help, since the milk will provide an instant reward for latching and may promote suckling.
For a baby who thrashes and scratches, you can swaddle him and/or put his hands in mittens or just little socks.
Comfort nursing is really important for a baby this age, so you don't want to limit it. But if your baby is comforting himself for hours on end, sucking erratically and lightly, you can take him off the breast, burp him and change his diaper, and latch him on again if he fusses. Let him nurse, just try to get him latched on as well as possible during the long evening cluster feed.
Hang in there, mama! I know from experience that what you are doing is very difficult, and it seems like there can't possibly be a light at the end of the tunnel. But there is!!!
Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
Coolest thing my little girl sang recently: "I love dat one-two pupples!"