The demographics of children in the United States and the determinants of child health outcomes are evolving rapidly. This evolution will require those responsible for children's health and well-being to acquire new skills and access new resources in the future to ensure the relevance of the field of pediatrics to the health of children. The objective of this article is to define a new paradigm for the practice of pediatrics that integrates the knowledge, attitudes, and skills of pediatrics with the principles, practice, and resources of public health to address the current challenges to child health in the United States. Historical and contemporary advances in the understanding of child health provide a precedent and framework to facilitate this integration.