Spit up that is pink with red flakes?

I post in both the FY and SY forums now, but since most moms dealing with reflux babies are in the first year I am posting this here

Brandon was on Prevacid solutabs from the time he was 4 months old until about a month ago shortly before turning 1 year old (he is about 10 months old adjusted now). After we first stopped the prevacid he seemed to do fine, but after a week or two he starting puking up occasionally, and sometimes projectile vomiting. When that first started happening he was sick with a cold so I attributed it to that. Then 2 weeks ago, while really sick with his second cold, he puked up in his crib and it was pink with reddish flakes in it. It looked JUST like the crushed red pepper flakes my husband had recently put on his pizza a few nights prior to that. I could not figure out how we would have dropped enough on the floor (and not notice) and Brandon to ingest enough to make him puke, but since it looked so similar to the crushed red pepper we figured that was the culprit. Since then Brandon has projectile puked a couple more times and had a couple of regular pukes, throwing up most of his bottle when he does (it's a huge, stinky mess!). I started to suspect that his reflux hadn't cleared up after all so I ordered him some more Prevacid by mail the other day and it is set to be delivered today. But here is the thing that worries me: when I went home today I realized that Brandon had puked up in his crib at some point during the night or morning and it was pink with those red flakes in again. It looked just like crushed red pepper again, but I know its not that as we threw away that packet after the last incident. So now I'm thinking it is probably blood He did have a few pieces of watermelon last night for the first time, but 2 weeks ago when this happened I don't think he had any red food prior to his pink vomit.

I'm just surprised that if his reflux is bad enough to cause him to puke up some blood, that he doesn't have more issues feeding, such as rejecting his bottles and being more fussy during feeds. And he doesn't puke every day, but maybe once every 2 or 3 days. And most baffling is that he has never had a big puke like this while at day care, if it happens it only happens during the evening or his morning bottle.

So I guess what I am wondering is whether anybody else had a LO with reflux that caused them to puke up some blood? And if so did meds such as Prevacid take care of the problem or did they have to do extreme tests? I did call and speak to the pedi nurse just now, and she said just to monitor Brandon for a few days and make sure there is no blood in his stools or mouth and in the meantime start him back on prevacid. I guess I'm just looking for some words of wisdom from anybody whose LOs may have experienced similar issues. TIA!

 

I have never seen reflux with blood in it. I would see if it occurs again like the Nurse says and go from there. Sorry I cant be of more help. :hug: Have you switched formula or offered anything new in the food category?

 

Thanks for your reply, and those are all great questions. We recently transitioned them from Target brand formula (derived from cow's milk) about a month ago. It was a veeery slow transition. They had 50/50 formula with organic whole milk for about 10 days. And then it was 75/24 whole milk to formula for another 10 days. And initially Brandon had no problems at all. His sporadic vomiting only started approximately 1.5 week into the shift to whole milk. But given that he was taking formula fine that was derived from whole milk I didn't think his recent puking was related to that but more likely reflux instead, and his pedi agreed on Monday when DH took him in for an ear check then. She also said we couldn't rule out a milk allergy yet either but thought that was unlikely given his history.

And yeah, it doesn't seem like reflux normally causes blood in the vomit. From googling that seems to be very rare and they generally request that you call the pedi asap. Also, I did give Brandon a few small bits of watermelon yesterday for the first time. Previously in the day he had no red foods at day care. I guess it's possible that the red flakes and pink puke are from watermelon. Though I don't think B puked until the wee hours of the morning, probably at least 8 hours after eating some water melon chunks. And water melon seems very porous, unlike dense foods like beets, so I am surprised if the melon caused that spit up, but it very well could be the cause. Watermelon was NOT the cause of B's pink speckled puke 2 weeks ago though, because he had nothing red to eat all day then.

Anyway, we gave B his first dose of prevacid in a over a month. I sure hope that within in a few days he doesn't puke up at all!

Thanks again for your response. I reckon we'll just monitor and hope that the prevacid gets B back to normal (and fast!)

 

I think I might be tempted to put him back on the formula that you know he was tolerating well until you can be sure of what's going on. Maybe it is a milk allergy, sometimes these things take some time to fully declare themselves.

 

totally agree with tina. cow's milk formula and whole milk aren't automatically tolerated equally well. with my boys we saw a flareup of diaper rash when we made the transition, which i've read can be fairly common. we didn't have a resurgence of reflux with the milk transition but we definitely didn't see reflux disappear right at 1 year.

transitioning back to the formula he tolerated might help eliminate a variable. that's the trouble with digestive problems, if too many things change you can't figure out what the cause was.

 

AHA. The flecks I would bet are watermelon. You should see what it looks like when it comes out the other end. Oh, I bet you did. It looks the same. :lol:

And...I would be the cow's milk is your issue. Most reflux babies have a milk protein intolerance and also soy as well. I might go back on the formula for another couple of months especially since they are technically not a year yet. It's higher in calories than milk anyway and then maybe try to wean again. We waited until Derek was over a year to do the transition and he did just fine. I would bet in another couple of months he will outgrow the allergy.

 

The other possibility since he's been really congested lately is that he could have had some bleeding in his nose that he swallowed wile sleeping. It can look like red flakes or streaks because there's not a huge amount. Blood from the stomach almost always looks like coffee grounds because of the stomach acids working on it. The other possibility is that some kids have a vomiting episode that is forceful enough that it causes small tears in the upper esophagus and this can cause bleeding. It usually goes away if the vomiting stops. If he's been on milk based formula and had dairy foods (yogurt, etc) then its not going to be a milk protein intolerance but the lactose in the milk could be higher than in formula and may irritate. You could try soy milk or lactaid if you don't want to go back to formula.

 

Thanks for all of the replies. And I wanted to give a quick update. Brandon has been taking his 15mg prevacid solutab daily again since June 10, and we have kept him on whole milk. And he hasn't projectile vomited or had a big spit up since then. Nor is he hoarse anymore. Yay! So apparently his reflux never fully went away and we'll just need to keep him on prevacid a bit longer. I REALLY didn't want to go back to formula, but would have if the prevacid had no effect on his recent vomiting.

 

glad to hear the prevacid is working. our GI specialist told us that it takes anywhere from 10 days to 3 weeks for reflux meds to really show signs of being effective, because the tissue that's been damaged by the acid has to heal over and stop hurting.

prevacid totally saved our bacon, and hopefully your LO will continue improving. :good:

 

My twin boy has spit up blood. He was on Prevacid from 2 - 9 months of age and weaned without a problem. He was on Zantac before, did nothing, went to a GI specialist, changed to hypoallergenic formula (no change) so switched back to Target (regular). Once he started taking the Solutabs at around 3-4 months of age, he never spit up blood again. It was probably irritation that caused a little blood to come up with the spit up (he wasn't on solids at that age). However, they did check his hb levels to see whether they were normal to make sure he wasn't bleeding somewhere in his body (although it definitely didn't look like that).

 

I'm so glad the meds are helping! I was wondering just the other day how he was doing. Thanks for the update!