My 4mon constantly spits up. been on zantac (ranitidine) for 3 months. no temp or loss of appetite. i'm afraid of aspiration. what's the next step?

Worsening GER: There are two top things to consider: 1. The dose of ranitidine needs to be adjusted or changed. 2. Your baby has a condition other than or in addition to acid reflux. Aspiration is a serious concern which can be evaluated with specific radiographic tests.

Review feedings: If there are no signs of distress, poor weight gain, blood in stool or vomit, I would suggest reviewing feedings with your pediatrician. Feeding your baby at a 30 degree angle, thickening feeds with rice cereal may help reduce the spit ups. Feeding small amounts frequently is preferable to large quantities less frequently.