Aotearoa New Zealand has high rates of early childhood respiratory infections such as bronchiolitis and pneumonia leading to hospitalisation 3-5 times that described in other OECD countries. These also demonstrate health inequity with greater numbers coming from our under-resourced Māori and Pasifika communities. While the acute event can be disturbing and disruptive for the child and the family, this can have a longer term health impact. Early hospitalisation, especially in the first year of life, is associated with repeated admissions and then later development of chronic respiratory disease such as preschool wheeze, asthma and bronchiectasis. Children later diagnosed with bronchiectasis had a mean of 4 lower respiratory tract infections, 2 requiring hospital admission, in the first year. The development of preschool wheeze and later asthma has been associated with repeated bronchiolitis, with stronger links described from certain infections such as RSV. Furthermore, these early index events may also impact respiratory function and health in adults – preventing attainment of peak lung function and increasing susceptibility to developing chronic respiratory disease in adults.