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Literacy is the ability to read, write and understand print. Proficiency in literacy is fundamental to social inclusion and strongly linked to health outcomes. Thus, improving literacy is important for lifelong health promotion. Poverty, inadequate hearing, speech and vision and learning disabilities may challenge literacy development. In our review, we explore these topics and suggest recommendations to: Mitigate the Effects of Poverty, Access Comprehensive Medical Assessments, Promote Early Childhood Education and Advocate for Early Intervention and Remediation Programs.

Mitigating the harmful effects of adverse social conditions is critical to promoting optimal health and development throughout the life course. Many Canadians worry over food access or struggle with household food insecurity. Public policy positions breastfeeding as a step toward eradicating poverty. Breastfeeding fulfills food security criteria by providing the infant access to sufficient, safe and nutritious food that meets dietary needs and food preferences. Unfortunately, a breastfeeding paradox exists where infants of low-income families who would most gain from the health benefits, are least likely to breastfeed. Solving household food insecurity and breastfeeding rates may be best realized at the public policy level. Notably, the health care provider’s competencies as medical expert, professional, communicator and advocate are paramount. Our commentary aims to highlight the critical link between breastfeeding and household food insecurity that may provide opportunities to affect clinical practice, public policy and child health outcomes.

The 'forgotten years' of middle childhood, from age 6 to 12, represent a critical period in child development. Emotional, social and physical development during this time have a lifelong impact on health and adult contributions to society. Mental health conditions have displaced physical illness as the leading childhood disability. Positive parenting can improve child behaviour, prevent early-onset conduct problems and provide a buffer from adverse childhood events resulting in decreased toxic stress and improved health. Medical homes can play a key role in supporting parents with positive parenting skills that are practical, evidence-based and useful in everyday life. Paediatricians need to explore the domains that promote healthy development, including caring environments, fundamental needs and nurturing relationships. Our objective is to promote high-quality positive parenting through middle childhood by identifying opportunities for paediatricians to frame parenting discussions in the context of development, behaviour and safety and to provide access to valuable parenting resources.Les « années oubliées » de la phase intermédiaire de l’enfance, entre l’âge de six et 12 ans, sont une période critique du développement de l’enfant. Pendant cette période, le développement émotionnel, social et physique a des conséquences permanentes sur la santé et l’apport de l’adulte à la société. Les troubles de santé mentale ont remplacé les maladies physiques comme principale affection de l’enfance. Des pratiques parentales positives peuvent améliorer le comportement de l’enfant, prévenir les troubles des conduites d’apparition précoce et limiter les événements indésirables de l’enfance, réduisant ainsi le stress toxique et améliorant la santé. Les milieux médicaux peuvent beaucoup contribuer à soutenir les parents afin qu’ils acquièrent des compétences parentales positives pratiques, fondées sur des données probantes et utiles dans la vie quoti- dienne. Les pédiatres doivent explorer les sphères qui favorisent un développement sain, y compris les environnements attentionnés, les besoins fondamentaux et les relations aimantes. Afin de promouvoir des pratiques parentales positives de qualité tout au long de la phase intermédiaire de l’enfance, les auteurs visent à cerner les occasions que peuvent saisir les pédiatres pour structurer les discussions avec les parents sur le développement, le comportement et la sécurité et les orienter vers des ressources intéressantes sur ce type de pratiques.

ifty years ago, health care for low-income children and families was described as “episodic, fragmented, crisis oriented, and anonymous” (1). Currently, children continue to face similar chal-lenges, and conventional medical care only begins to address a small portion of these concerns. The ‘third era’ of public health will need to focus on optimizing health and well-being through primary prevention, health promotion and community-integrated delivery systems (2).As community paediatricians, we remain powerful advocates for children, families and communities because of respect from parents, altruism and knowledge of resources (3). We understand that advocating for an integrated and high-quality community health system with ‘upstream’ health promotion and prevention requires collaboration with community agencies, multisectorial partners and health care providers (3). By directly addressing social determinants with positive health-promoting influences – such as early childhood education, family support, primary health care and behaviour/mental health services – we can achieve opti-mal population health and health equity by breaking pathways of social risk and poor health outcomes (4). The Canadian model of community health centres (CHCs), in alliance with the evolving role of the community paediatrician, provides an ideal place-based community setting to create innovative solutions and address ongoing concerns, while not attempting to fulfill all characteristics of the community paediatrician (Table 1). This CHCs-community paediatrician model can create a broad gamut of services that range from clinical consultation, school-based health care, child-, adolescent- and family-based programming, to board governance and policy, building needed child health infrastructure.