Maintaining your facility’s Texas Ten Step designation reaffirms your facility’s commitment to offer highly supportive care to breastfeeding mothers. 

Now that your facility has the basics of the Ten Steps down, we strongly encourage and support your continued growth in these standards. 

Non-Baby Friendly Hospital Initiative (BFHI) Designated Facilities

Facilities are required to re-designate every two years by completing a full application (PDF). Include all support documents with each step even if your documentation has not changed from the previous designation.

BFHI Designated Facilities

As a Baby-Friendly facility the deadline for TTS re-designation will align with your BFHI re-designation. It will be due every 5 years on the same month and year listed on the Baby Friendly USA website. For re-designation submit the full application and support documents even if documentation has not changed from the previous designation.

Preparing your Application for Re-designation

During your facility’s initial designation, practice and policy recommendations are provided on the Scorecard to guide your improvement and next steps. 

In your application, highlight where any changes were made based on previous recommendations and include information on new Ten Step initiatives. Notify the Texas Ten Step Program Coordinator if your facility’s contact person has changed between designation years.

  1. Review your individual Ten Step Scorecard Evaluation Tool for change recommendations.
  2. Use the Ten Step Facility Self- Assessment Tool (PDF) to help plan for step-by-step improvement.
  3. Refer to the Baby Friendly USA, Inc. Guidelines and Evaluation Criteria to fully implement the Ten Steps.
  4. Review the support documents list to ensure you’ve included all your Ten Step support documents.
  5. Set-up a Ten Step review call with the program coordinator, if needed, to ensure your application is ready!

If you do not have a copy of your facility’s previous Scorecard Evaluation Tool, email to request a copy.

Our TTS scorecard has been revised!

Visit the Scorecard Evaluation Tool page to learn more about the updated criteria.

Sending the Application

Sending Application by Email (Preferred):

  • Send separate emails for content related to each step. Title subject line with “Step No. – Support Documents" For example, Subject: Step 1- Support Documents.
  • Please note that all support documents must be included with each step even if your documentation has not changed from the previous designation application.
  • Email to:   

Sending Application by Mail:

Mail to:
Texas Ten Step Program Coordinator
4616 West Howard Lane
Bldg. 2, Suite 275, MC 4554
Austin, Texas 78728

Do not send application and documents in a three-ring binder as there is no capacity for storage.

Re-designation Review

Once your facility’s application has been received, the Program Coordinator will contact you by email or phone to review any additional questions and to ensure that all necessary documentation is received. 

The final review of your application may take several weeks to complete.

Texas Ten Step Program Coordinator

Mom nursing baby