Adults who provide early care and education are critical for the healthy development and well-being of young children. Although many people in the early childhood care and education (ECCE) workforce are skilled and dedicated, their ability to provide high quality experiences for children is hampered by a lack of shared purpose and identity, insufficient or ineffective training, poor compensation and lack of institutional supports. In this report, we build on The Early Childhood Care and Education Workforce: Challenges and Opportunities (2012), a report of a workshop held by the Institute of Medicine and the National Research Council with the goals of defining and describing the ECCE workforce, exploring workforce characteristics that affect children's development, and considering ways to build ECCE as a profession. One major theme in our discussion is the need for integration of the two policy streams represented by the terms "early education" and "child care." Both settings provide experiences that affect child development. Both can function well when the personnel are well-trained, sensitive, and skilled, and work in supportive conditions. One feature of an integrated ECCE system is a unifying definition of the profession, a goal that could be promoted by revision of the federal occupational definitions and fostering federal and state collaborations around data. Policies to promote integration also include developing common goals, administrative systems, quality standards, and professional development activities. Quality ECCE hinges on building an effective workforce through professional development that promotes the use of effective and evidence-based practices. Improved working conditions would include adequate compensation and opportunities for advancement and recognition. We identify two broad policy goals for public agencies at all levels of government and professional organizations within the field: using current funding streams to promote quality and building public will through communicating the importance of policies and programs that enhance early childhood development.