With this section, I review five areas of concern to the pediatrician in the office setting: sudden infant death syndrome, child maltreatment, oral rehydration therapy, infectious diseases, and vaccinations. In keeping with the structure of Current Opinion in Pediatrics, I focus on these topics through the vantage point of this past year's literature. I would be amiss, however, if my commentary neglected to integrate the impact of major factors, often regulatory, on pediatric practice and to acknowledge the precarious nature and thus the renewed challenge of children's health in the United States today.