texastenstep.org

What It Is

Texas Ten Step (TTS) is a breastfeeding best-practice designation and support program for birthing facilities in the U.S. state of Texas, with designation provided by Health and Human Services. It is not a traditional online course platform for individual learners; rather, it is a public health program that helps hospitals, obstetric units, and neonatal care teams build policies, train staff, and improve care practices around the “Ten Steps to Successful Breastfeeding.”

Core Content

The program centers on facility designation, application support, redesignation, training resources, and breastfeeding advocacy. TTS facilities are required to submit breastfeeding-related data and continuously advance evidence-based care practices, such as reducing unnecessary mother-infant separation, avoiding non-medically indicated formula supplementation, and increasing coverage of staff education and skills training. In terms of training, the main content mentions that Texas WIC partner training sites provide both online and in-person training. Facilities may also use in-house or outsourced training, but they must submit materials such as course content and skills checklists.

Pricing and Certification

TTS designation is voluntary, valid for two years, and explicitly has no application or maintenance fees. It differs from the Baby-Friendly Hospital Initiative (BFHI): BFHI is a higher-level global gold standard, while TTS is more like a Texas-based phased quality improvement framework that can serve as a transitional pathway for facilities working toward BFHI.

Pros and Cons

Its strengths are that it is free, has a strong public health foundation, offers clear standards, and provides application documents, training resources, and ongoing support, making it valuable for promoting breastfeeding policies within hospitals. It also emphasizes patient satisfaction, quality of care, and long-term health cost benefits. Its limitations are that its scope mainly applies to Texas birthing facilities; TTS designation is based on self-reporting, with limited external evaluation intensity; and the website content does not disclose full course duration, a detailed list of instructor qualifications, or specifics about the learning experience.

Who It’s For and Access from China

This program is suitable for Texas hospitals, obstetric administrators, NICU/mother-baby care staff, lactation support teams, and institutional quality improvement leaders. It is not suitable for ordinary parents looking for a structured parenting course. Access from mainland China is not mentioned in the main content, so its availability is unknown.