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        A mom called today to ask about her 2 mo old breastfed baby having "white
clumps" in his mouth following feeds.  Baby is being treated with Nystatin
 for thrush, but she says what she is asking about is not thrush.  It seems
 that the baby spits up "white clumps" following some feeds.  No projectile
vomiting.  Gaining well, with plenty of diapers. The problem is that the
pediatrician told her she should give feedings of Isomil with  1 tsp of
 cereal per oz to solve the problem of the spitting up. This mom worked
very
 hard to establish breastfeedig and hung in through very sore nipples.  I
am
 concerned that following the md's orders will compromise breastfeeding.
She
 called me for advice after seeing the MD and has not yet given the abm or
 cereal.  Can this spitting jeopardize the baby in any way as long as he is
otherwise healthy? If he has reflux, is that really a problem?  Can I
 advise her to just continue breastfeeding and ignore the spitting?  Thanks
 in advance for any advice.    Anne