You are right Janie...it generally is a poor attachment issue. I think it happens to us "perfect attachment" girls when the baby goes ON correctly, but kinda pulls back when the flow gets too much (as was the case with me). This is how I kept getting the "lipstick" shape. The solution is to take bub off and re-attach.

In the end my nipples toughened up on their own so I don't need to re-attach her myself, she just sucks the nipple back in her mouth again.

Ah..time heals all ills it seems, but in the meantime, you are right. You have to take care of those nipples and re-attach, re-attach, re-attach....so it stays correctly in her mouth.