The landscape for families is changing at a rapid pace. Managed care has left its stamp, perhaps indelibly, on the way pediatrics is practiced. Income inequality is increasing, and racial disparity in health remains. The media has saturated families with more information than they can process and spawned a culture for children that seems to change almost daily. At the same time, children are exposed at earlier and earlier ages to ideas and behaviors most of us have difficulty making sense of, even as adults. The world facing families with young children offers great promise, but also significant challenges.

The dizzying pace of change may affect the content and duration of pediatric primary care visits, but the structure of those visits will probably change very little. The pediatric clinician will likely continue to see a child on at least eleven occasions for well-child care in the first 3 years of life and at least several other times for sick visits. Pediatric clinicians will almost surely remain the professionals who see families with young children most consistently. Indeed, for many families, pediatricians are the only professionals who see them together, in a family context. These visits come at a time when parents are extremely receptive to professional support, information, and advice. Findings from The Commonwealth Fund Survey of Parents with Young Children indicate, for example, that mothers are more likely to breastfeed if a physician discusses the advantages of the practice with her.