This article discusses why and how the "State of Babies Yearbook: 2019" was developed; identifies the indicators used to examine the well-being of the nation's infants and toddlers; and explains how the indicators align with the ZERO TO THREE policy framework areas of Good Health, Strong Families, and Positive Early Learning Experiences. The author describes the methodology used to rank and compare states and summarizes the national findings and variations found among states. The article provides recommendations for using the Yearbook data to inform and promote development of national and state policies that ensure all babies have the opportunity for a strong start.