Topping up due to static weight

[Slanketeer]

I have a 12 week old exclusively breastfed baby who up until now has stayed on the same centile line for weight. This last week he hasn't gained any weight at all however. The underlying issue is that he can't open his mouth very wide which he's getting physio for. In the meantime now that his weight isn't going up I assume I need to start giving top ups but I have no idea how many mls to give at each feed or over the course of the day to get his weight back on track. I've tried contacting our health visitor and infant feeding team but not response! Would really appreciate any advice!

Sounds like you're doing a great job so far! Breastfed babies can often not stick to the centiles so to get to 12 weeks sticking to the centile is really good. Is baby being weighed regularly for you to know this week is different? Are there any reasons why? If baby's nappies are good (at least 6 heavy wet nappies in 24 hours) it may just be worth keeping an eye on it for a few days whole you wait to hear from your infant feeding team.

It might also be worth making sure when baby is feeding they're 'actively' feeding and you can see the sucks and swallows. By 12 weeks the latch can also sometimes need revisiting so maybe worth going back to basics and making sure baby has a nice deep latch. Your local breastfeeding support group should be able to help. The NHS website also has some useful information.

Introducing top ups can be necessary for babies where they're unable to effectively transfer milk but from what you've described baby has been doing really well. Top ups can lead to all number of challenges (search the 'top up trap') getting back to breastfeeding so should be done carefully when baby needs it. If you are advised to top up, have a look at paced bottle feeding which can help to avoid bottle preference and any interruption with breastfeeding.