Health visitor visit - advice needed on feeding

[girl78]

Hi just after a bit of advice!!
My 13 week old was weighed today and although she has put on weight she has gone down two centiles which the HV suggested we keep an eye on and I'm taking her to get weighed on Tuesday to see how she is getting on.
Since having her weighed this morning I've kept more of an eye on how often she feeds.
Since 12 she has had 3 feeds, 2 poos and 3 wee's that weren't particularly heavy. After her second poo she hasn't had a feed and has gone to sleep. Her last feed I felt she wasn't quite finished but kept pulling away so I offered her a bottle of formula that I had spare. She then drank all of that in two separate sittings. She is breastfeeding normally.
So when she has been pulling away after a feed previously, I've assumed she has finished a feed but could it be possible she still wanted more but I didn't enough enough supply?
Also, my questions are;
A) should I be concerned about the dropping in percentiles
B) if her wet nappies aren't particularly heavy what does that mean?
C) should I be offering her formula feeds?
D) should I try and feed her more, I offer her feed but she just doesn't take it if she isn't hungry. So I don't know how I could feed her more than she actually wants

The dropping of percentiles might be something as boring as you measured her last time just before a poo and after a feed, whereas today her tummy was empty. It's good to keep an eye on it and check her out on Tuesday.

Maybe she's sweating a bit more and that's why she's not weeing so much. That could also be why she's down a couple of percentiles?

Up to you! It might mean that you stop breastfeeding a little sooner than you planned or it could be the start of a great combi-feeding routine for you both. Babies are mysterious. I wonder if the hv could give you more information about breastfeeding or put you in contact with an expert/peer advisor or something.

She might be a little-and-often baby. It's hardcore because you're feeding all the bloody time for the first few months. She might be pulling away because the flow of milk is too fast for her so you could hand express/pump for the first couple of minutes to take the edge off. A breastfeeding advisor would know more though.

Good luck and you're doing great!

Do you offer the other breast every time she stops or pulls off?

Might she be pulling away because she needs to burp?

Thank you.
Yes. I do offer other breast and I do try to wind her but sometimes get distracted with older DD so she gets put down quicker than she might be ready to?
Fantastic first answers

My 12 week old ebf baby was weighed by the health visitor yesterday and has gone from 50th to 25th centile. She wasn't worried at all as he'd still put on a good amount of weight since last weighed at 8 weeks. He'd just done a massive poo which she said could have made a difference too.

Re the heavy nappies- how often do you change her? I change him every 3-4 hrs (immediately if he poos) and they're usually quite heavy then, much lighter if it's more frequent than that.

I always offer both sides at a feed. He usually accepts even if pulled off first side.

We had a similar dip at this age, one thing to check is that the scales were the same and that they have been calibrated, otherwise the measurements are pretty meaningless.

DD (and me) was easily distracted by older DC too. I made an effort to offer her a feed every 2 hours in the day and it seemed to help. Pulling away from the breast isn’t an indicator of a supply problem either, have a look at My Baby fusses or cries during breastfeeding, what’s the problem? on Kellymom.

If you want to supplement, and nothing you’ve posted suggests a need to, could you offer feeds more frequently and then I found needed, supplement with ebm instead?

Ho might I increase my baby’s weight gain is a useful article too.

In your situation, I’d also be calling one of the Bfing Helplines for some support to and to talk through how you are feeling. Have you got the numbers?

Just because a baby is tiny doesn't mean they're going to be a tiny adult and vice versa. It's entirely normal for babies to find their natural centile and move up or down the chart at this stage. There's always one HV who gets hysterical about it though and scares the mum to death...

Usually when mine does that, it means he needs to be winded. If she is content after though, then she's probably finished. I wouldn't necessarily be worried about the centiles. See how it goes in another month or two. A baby that is hungry, generally speaking, will eat. If she isn't interested when you offer her the other side, I'd say she's done and not stress about it too much. I would feed her as much as she wants, whenever she wants, and not offer a bottle. By now, your body will make breastmilk on demand as your supply should be established, so if she wants more, she can easily get it if she wants it. It's possible she's just about to have a growth spurt too and it can be normal for weight and feeding to dip just before. I'd just keep doing what you're doing if you're otherwise happy to.

I was just thinking: On hot days my baby used to pull away because the milk was getting too creamy and she wanted the other side because there was more watery fore-milk there.