Kelly, if you feel ripping, please express (and don't keep pumping if that feels like its ripping too (it shouldn't) - just hand express if you can, works well if you can get the practise in). I have had a piece of nipple rip off, it was long, about 1.5cm and about 2-3mm wide and the way the tissue grows, it rips all the way around
It hurts and can take ages to heal.
Are you prepared to express and bottle feed EBM? It may give you nipples enough of a break if you do that when you can. Logistically, I don't know how, I used to feed DS and pump while he was in his bouncer after a feed - I'd sing to him and he'd be pretty happy but not sure what options you have for hands-free and boobs-available with C being so unsettled with the reflux. Just reading again that its mostly the night feeds - is he going further apart at night? Could be extra milk flow as you're resting (if you are).