Whne my son was a baby we ended up with lots of spit-up on his white shirts and sometimes I'd get behind with the laundry and they'd really set in. The only thing that got them out was Shout, but make sure it's the gel kind with the scrubber on the top of the bottle. If you use something other than Shout, try scrubbing it with an old toothbrush to make sure you get all the way through the stain.
I've found that Awesome Oxygen Cleaner (the dollar store version of OxyClean) works great on formula stains and spit up stains on clothing ... I bet it would work well on your mattress too!
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