June
I would not think an oral assessment was necessarily indicated, however, see 
below about tongue tie.
If baby has been fdg well for 11 wks, then something is new, it seems. I 
would look at foods or meds in mom's diet, return to work issues affecting 
supply, placing routines on baby such as sleep training routines, pregnancy, 
hormonal birth control affecting milk supply and/or composition, infant 
illness like ear, or even something like cystic fibrosis.
I am not totally doing the math, but at first glance it seems baby gained 
about 1500 gms or 3 lbs in about 3 months. This is on the low side. It is 
also possible infant has some degree of tongue tie which has compromised 
milk intake and supply.
The infant needs a thorough health assessment and mom needs much support to 
maintain/increase her supply until the problem can be worked out.\\good 
luck.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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