DCB is about 16 -17 months old. As a baby, he spit-up a lot!!! but they never found out the cause. They even put him on meds. After taking him off the meds his spit up decreased significantly. Now he is over and year and he spits up every few days, sometimes following a burb, mostly after milk and the milk comes out in a liquid form. Sometimes, it comes out looking like cottage cheese.

I contacted DCM today after the second spit up and she questioned me claiming it was from teething. Help me fight this one.
I attached a picture tell me what you think, it this teething related? Spit up? Would you send home?

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Spit up at 16-17 months? NO. Not without GERD or some other diagnosis. I would honestly treat this as vomit. (same contents)

Could he have a dairy intolerance?

Hey dcm, I have noticed this happens frequently after he has dairy. Is it possible we have overlooked a dairy intolerance? Dcb seems very unhappy when this happens, and in all my years of childcare, I have never seen spit up beyond a year for any reason.

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DCM thought he might be at 12 months, she wanted the doctor to sign the food program form for an alternative milk but he refused. He will on occasion spit up after string cheese but not every time. He eats any other cheese and yogurt without any issues.

DCB never seems unhappy, he always just continues on as normal. He will even continue to eat after he spits up.

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Hmm, that does not look like spit up and at his age, eating solid foods, there’s really no longer such thing as spit up. It’s vomit.

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I'd send home.

Throw up is a sanitary issue and even if it was from teething (which I do NOT buy) he still needs to go home because he threw up.

He is no longer on meds so no medical issue and his Dr refused to sign the special diet statement therefore there is nothing dietary that would cause him to throw up.

So since all of the above has been ruled out, he is sick.

Sick = excluded.

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I literally just had a 15mth old spit up last week. She burped really big then spit up a little. I was so shocked that I couldn't believe it. She hadn't even had anything to eat or drink in almost 3 hours. After that, I researched a little and it is possible for a child that age to spit up but the occurrence of it should be rare and not a consistent thing. If he is doing it repeatedly, it's from a bigger problem. Dairy intolerance was the leading factor noted in everything I read about spit up in toddlers. Also, the temperature of the milk can cause spit up too apparently if the child has a sensitive system. Apparently if it is too cold it can cause them to spit up and it is recommended then to try serving it warmed. All that said, the photo you posted doesn't look so much like spit up to me. It looks very chunky which would lead me to think it was something different, like actual vomit. Could just be the photo though. I'd have the parents get it checked out with his doctor. Allergies and intolerance to dairy can happen at any age so if he is developing an allergy or intolerance it would be good to know sooner rather than later.

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Yes, it really is chunky. Some mornings, I have time to pour milk for the kids while I get dd lunch ready for school. This morning I did not have time to pre-fill their cups. I will have to note that, for a while and see if he only spits up on cold milk days.

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That LOOKS like dairy problems...it's curdled milk.

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Also, doctors no longer need to sign the dairy sub form...as long as it's an approved soy milk.

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This was my thought. Did you send home? I am curious what mom said.

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Long story shorten, I ended up having a family emergency and let all parents know I was closing early. She sent dcd and he was the 1st to pick up. (He was not working.)

I have not talked anymore to DCM about the "spitting up". He did it again today about an hour and a half after eating waffle and oranges and milk that sat out on the counter to warm up. I found the spit when I was cleaning up during nap time. ugh. (the picture is zoomed in)

If anyone has some links or suggestion on where to find info on how to treat, let me know. I want to talk to dcm about this, I just know her and research and documentation will go along way with her.

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I hope all is okay

Does DCB cough or gag at lot? Does he have breathing problems like congestion or difficulty breathing? How often is he spitting up?

Sounds like GERD to me and many foods (not just dairy although it is the most common culprit) can cause reflux symptoms.

Also, I would watch for signs of silent reflux. Does he seem to burp and swallow after? Does his breath smell acidic?

It is also possible he is eating too fast or too much. Those can also cause GERD-like symptoms. Drinking too much fluid at once could also cause this.

I would mentioned GERD to mom (again.) If he has uncontrolled GERD the acid is going to eat away at his teeth and will lead to dental issues. LOTS of children with un-diagnosed/uncontrolled GERD end up with deep cavities on their molars from the acid.

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Just re-read. A few thoughts, they may or may not apply here.

1) if he is a "happy spitter" the pediatrician is not likely going to care.

2) He does this most often after milk? Could he have a lactose sensitivity? Maybe try a lactose free milk and see how he responds to that.

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Ok so it's not just milk then. At this point I'd guess GERD. Poor kiddo.

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I have never noticed any gagging. He coughs but not while eating, (he gets colds a lot). No breathing issues. Today he "spit up" twice, one day he spits up 3x while still eating. (I never really tracked it, just kinda got used to it.) Sometimes it is at the meal or at the end but like today I found it in there play space.

When I do catch him spitting up, I have never heard him swallow or burp after, I have heard him burp before. Today after his second spit up I could have sworn that I smelt vomit when I was cleaning him up.

"happy spitter" is exactly what the ped told DCM that dcb was, since never cries after spitting up.

I am required to serve milk but I plan on tracking his spit ups for a while and then reapproach dcm with data.
DCB second spit up was after crackers and yogurt.

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Coughing while not eating is common with GERD. As are frequent colds/nasal issues.

I like your plan of observing, documenting and approaching mom with data. So many people think GERD is simple heartburn, for a few it may be. But for many it is a lifelong illness that effects SO MUCH, especially when uncontrolled. Knowing what we know now DH thinks he had GERD as a child. And because it really wasn't a "thing" and was uncontrolled he has many scary issues as an adult. It's really something that puts a lot of tear on one's body. And although medication can help it is not the solution. Many need lifelong diet changes which include avoiding certain foods.

Anyway - getting off my soapbox now I just hate to think of a child who may be silently suffering. I also know this must be super frustrating for you

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http://www.reflux.org/reflux/webdoc0...m?OpenDocument

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