EBF 3mo dropped two centiles... :-/

[Flingmoo]

Not sure if this comes under feeding or development but here goes.

HV came today and our 3 month old has dropped from 75th to 25th centiles since birth, despite good weight gain at the beginning. He's now 12lb 9oz.

He is EBF on demand although recently I haven't been noticing any "demand" (feeding cues - head bobbing etc) and I've just been randomly offering feeds throughout the day, never going more than 2 or 3 hours. Sometimes hourly or more during his awake time. He chews/sucks his fists constantly but has done so ever since he discovered them so I usually assume this is not a feeding cue. He drools a lot so also possible teething.

He's been quite sicky recently - pukes at least once after almost every feed although it's not projectile or huge quantities.

No major feeding issues as far as I know, he's a bit fussy at the breast sometimes, but mostly BFing has been a breeze for us.

Any ideas - should I be worried? Anyone had a similar experience? I don't want to panic and go out and buy formula as I am really enjoying BFing...

Was he 75th centile at 2 weeks? the birth centile is irrelevant it comes from a different dataset, a baby born on the 75th centile should enter the charts at 2 weeks on the 50th centile and then a drop to the 25th centile would be totally normal growth.

If he has dropped two centiles from two weeks, then check is he feeding frequently enough (it sounds like it), is he swallowing frequently during active feeding? Is he well? does he have five or six heavy wet nappies a day (or more). If everything else is fine then there isn't really any reason to start formula.

A medical check up to rule out anything unusual like an infection or reflux could be useful or could be unnecessary but may reassure that he is okay (or reassure the health visitor) maybe reweigh in a month to check.
HTH

Thanks for the helpful response!

Yes, looking back at the chart he was on 75th centiles after 2 weeks but by 1 month he was already dropping slightly on the chart, by 2 months he was just below the 50th, and now at 3 months he's down to the 25th...

He seems to gulp his milk down nicely during feeds, not sure about the wet nappies, he definitely soaks through one or two at night and at least three during the day.

HV is coming back in a month to re-weigh and discuss possible reflux. GP had a look at his nappy area today as he's had a bit of a sore looking willy (!) and he's given him cream for a fungal or bacterial infection. Not sure if that would affect his weight gain though!