An 18 month old boy with cerebral palsy is brought to your office because of “spitting up” after feeds. It has been a problem for the past several months, but is progressively worsening and now occurs after every meal and even at night. He was breast fed for 12 months and has slight developmental delay. Height and head circumference are between 25–50th centile, but weight is below 5th centile for age. A barium swallow reveals significant gastro-oesophageal reflux to the pharynx. A …