Oh yes, Jack, you're quite right.  When I said "a couple of years" I used
the term loosely.  Mother has since had another baby - so maybe four years
ago - second baby did *not* spit up like this.  And in fact I've seen *very*
few - maybe 3 in toto, out of about 1800 mom-baby pairs so far.  This
particular one stuck in my mind because it was so dramatic, mother was so
horrified at first, but soon got used to it.  On the *very* occasional times
regurgitating through the nose has been reported I always explain that this
can happen sometimes, it's not cause for concern unless the baby is failing
to thrive (so far this has not happened, even remotely), just keep an eye on
the weight gain for a few weeks, and that the baby will grow out of it.
Positioning the baby more upright during breastfeeding can help, as can
keeping the baby at an angle of 45 degrees after feeding (to give gravity a
chance to help the milk go down).  Otherwise no problem.  So I do agree with
you that it seems to be rare in the general scheme of things.

Since joining Lactnet I've been interested to see others' opinions that
cow's milk proteins ingested by the mother can have an impact on reflux - so
I would enquire about this now too if I saw it again.

Regards, Pam