Recent advances in pediatric health, such as declines in child mortality, would never have happened without significant and consistent federal investment - supported by Congress and led by the National Institutes of Health (NIH). Despite these advances, there is broad consensus among experts that child health is in crisis as children in the United States are experiencing rising rates of chronic diseases and poor mental, emotional, and behavioral health. NIH tasked the National Academies with convening a committee to examine NIH's pediatric research portfolio and structure and to provide recommendations focused on improving NIH's overall support of pediatric health research. The resulting report provides evidence and eight recommendations to guide NIH's integration of a pediatric and life-course focus throughout its research and funding priorities.