There are many early-life risk factors for respiratory disease in children and adults, a number of which are preventable. It is important that prospective parents receive better advice about the adverse effects smoking could have on their infant. Effective prophylactic agents against respiratory viruses, particularly rhinovirus, need to be developed and evaluated appropriately. Invasive antenatal interventions, therapeutic or diagnostic, should only be introduced into routine clinical care after their impact on the infant has been carefully evaluated. Further, randomised trials with the outcome of respiratory status at follow-up are required to determine the best management of very prematurely born infants.