Denise,
I recommend lansinoh and attention to the latch on and suck for damaged
nipples.  I hesitate to recommend the mom take the baby off the breast, but if
she desires to do so, I tell her 24-48 hours, and advise she cup or fingerfeed
at least some feedings.  They almost always wind up using bottles at the
middle of the night feedings.
        I have the same experience that if the suck, positioning and latch on
can be corrected quickly, the mom can often stand to nurse on even 'cratered'
nipples.  The problem comes when the baby has a complicated problem which will
take time to resolve.  These moms either settle for 'better' and keep working,
or quit.  I wish we saw them earlier!
Catherine Watson Genna, IBCLC