Linkages between literacy attainment and poverty have been well documented in the literature. This article reviews the literacy challenges for low-income children and the need for child health practitioners to be informed about children’s literacy environments. The authors define literacy and emphasize that literacy is a continuous developmental process that includes listening, speaking, reading, and writing. Read Out and Read is a national model that has demonstrated its effectiveness to improve receptive and expressive language development in children. Pediatricians are uniquely positioned to address early child’s literacy development because they are often the only practitioner regularly encountering parents, infants, and children during the preschool years.