Children typically attend clinic every three months. Always present are the paediatrician, physiotherapist and usually a dietician. From time to time medical students or visiting paediatricians will also attend.

On arrival, a paediatric nurse will check the child's height and weight. From around age 5 the physiotherapist will also try and carry out a pulmonary function test (PFT) using a spirometer, to establish the child's lung function.**

The paediatrician talks to the parent with the child present, reviewing the child's health over the last 3 months. Respiratory and digestive issues are discussed specifically. General coughs and colds, antibiotic use, physiotherapy and any change in frequency of cough or sputum production. Appetite and growth, bowel motions and any stomach pains are discussed.

The child is given a physical examination which typically involves listening to chest and back using a stethascope, palpating the stomach and abdomen to feel for any lumps in the bowel, and finger tips are examined for signs of clubbing.

Medication is reviewed and new prescriptions written as required.

Once a year, usually around the child's birthday, a blood test is carried out to check for vitamin levels amongst other things. Chest x-rays are also carried out to monitor changes.

With regard to cross-infection issues, Wellington Children's Hospital CF patients do appear to attend appointments in succession, but usually at most passing in the waiting area as one patient arrives and another leaves. Physios are careful to clean each patient's hands and issue new mouthpieces before using the spirometer. Only when appointments are running late does there ever appear to be more than one CF patient in the waiting area.

Dr Alan Farrell, Paediatrician, is responsible for the care of all children with CF at Wellington Hospital.

**Lung function is tested specifically by measuring the volume and speed of air that can be inhaled and exhaled. The test result is given as a percent of the "predicted values" for the patient's height, weight, age, sex, and race. Results over 80% predicted are considered within normal limits. Accurate comparisons can only be made from mimum age 6+.