How to Apply

Welcome and congratulations on making the decision to assess and improve your facility’s breastfeeding practices! Your journey to create systems-wide change starts now and the Texas Ten Step (TTS) program is here for you every step of the way.

Start the Process

Information that you submit to TTS is voluntary and self-reporting. There are no external audits or site visits. We will provide technical assistance throughout the application process. Let’s get started!

Mother-Friendly Worksite

Step “Zero”- Texas Mother-Friendly Worksite Designation

Support breastfeeding by starting with your own organizational culture. Earning your Texas Mother-Friendly Worksite designation demonstrates your support and commitment to breastfeeding employees. Your Human Resource department can highlight this employee benefit with current and future staff. TTS designation is not awarded until confirmation of designation through the Texas Mother Friendly Worksite (MFW) program is received by the Texas Ten Step Program.

Become a Texas Mother-Friendly Worksite

Take the Training

Learn More About the Texas Ten Step Program

Learn more about Texas Ten Step, including why it’s important and how it works! Complete learning modules that: 

  • describe the program 
  • review how to complete the application
  • serve as a refresher course during TTS re-designation 
  • provide talking points to use with your leadership
  • assist WIC staff and other partners who serve as program resources in their community.


Take the Texas Ten Step Training (coming soon).

Download the Application and Scorecard Evaluation Tool to use as a guide during the TTS application training.

Form a Task Force

Build Capacity — Form a Ten Step Task Force

Create a diverse, multi-disciplinary team to help identify the tasks, priorities and conversations needed to advance the Ten Steps in your facility. This task force can seamlessly transition into the team the will help you achieve the Baby-Friendly Hospital Initiative designation.

Recommended task force members may include:

  • Facility CEO/ administrator
  • Lactation consultant 
  • Clinical nursing management
  • Physicians (e.g. OB, pediatrics, neonatology, hospitalist)
  • Nursing staff (all shifts and per diem staff)
  • WIC staff (peer counselor, director, breastfeeding coordinator, registered dietitian)
  • Quality improvement staff
  • Breastfeeding mother who delivered in your facility (non-staff member)

Learn more from the Institute for Healthcare Improvement on Forming the Team.


Tips for Success:

  • Divide and conquer. Divide the steps among team members to help build buy-in with the staff, leaders and community. Have individual members take ownership of the change process.  This will prevent the initiative from remaining stagnant due to competing priorities.
  • Engage leaders early and often. Meet with your leadership routinely to share your Ten Step goals and to share the value their support lends to this work. Communicate your success with a brief email, report or video message. Be creative and keep them wanting more updates and information!
  • Lead by example. Breastfeeding champions help plant the seed of change. Breastfeeding support staff, physicians that take the lead on breastfeeding research, or staff with a passion for breastfeeding education are key people that demonstrate the Ten Steps in action. 
Readiness Asessment

Complete Your Application and Gather Your Documents

Now that you are ready to start your application, learn more about the supporting documents that you will need to submit when you apply.

This is not an all-inclusive list; for questions on other documentation that can be submitted as a Ten Step support document, email TexasTenStep@hhs.texas.gov.

Access the Application and view the Support Document list for each step

Set Up a call

Setup Your Ten Step Review Call

You are ready to set up your Ten Step review call if you have:

  • Started your Texas Mother Friendly Worksite application
  • Reviewed the Texas Ten Step application training 
  • Completed your Texas Ten Step application
  • Gathered your Ten Step support documents.


Contact the Texas Ten Step Program Coordinator or call 512-341-4592, to set up an appointment to review your facility’s application with your team before submitting it.