The increase in single-parent families, step-families, maternal employment, and young children in substitute care are among several important changes in the American family in recent decades. Although it is not clear that these changes necessarily lead to negative outcomes in children, it is apparent that a variety of potential risks and challenges confront many families today. Pediatricians can play a valuable role by helping families to adjust and cope with certain difficulties, such as divorce. However, in other areas such as child care, changes in public policies and programs are needed to better support families to optimally nurture their children.