Hi,
I'm new to Lactnet and was interested in the discussion regarding the
mother with large breasts, flat nipples whose infant was experiencing
difficulty latching-on.  I work full time as a LC in a community
hospital where we do about 1500 deliveries a year.  We have a LDRP unit
and are just getting into water births.  It's been exciting here these
last few months!  I have the best luck in this type of situation if I
have the mother turn slightly, sitting on the her hip opposite the side
she wants to nurse from.  Place the awake, rooting infant on his/her
side facing the breast.  Put a rolled up diaper, washcloth, pillowcase
or crib pad underneath the breast, this lifts and supports it, there is
less weight against the baby's face.  Of course she could support it
with her hand, but new mothers often feel overwhelmed when they don't
have a free hand.  If the areola is soft, the infant is often able to
latch-on, taking in a mouthful of breast, nipple and all.  It is also
helpful to lift the breast during latch-on so that the nipple starts at
the infant's nose and comes down slowly into the infant's mouth.  The
underside of the areola helps to tickle the infant's lower lip
encouraging the infant to open his/her mouth wider.  I hope this helps.