Hospitals and maternity centers download an application from the North Carolina Maternity Center Breastfeeding-Friendly (NCMCBF) Designation Program page of the Nutrition Services Branch website The application is submitted with supporting documentation demonstrating compliance with the requirements for each step in the application. Using assessment criteria in the review tool, the NCMCBF Designation Program committee members review submitted applications. Review committee members utilize the assessment criteria and review tool to determine the award level for NCMCBF Designation Program applicants. Hospitals and maternity centers are awarded up to five stars based on the number of the Ten Steps they have achieved. Hospitals and maternity centers that receive a designation are provided a packet including a certificate of designation, logos to use in promotion of the designation, and a sample press release. These hospitals and maternity centers also receive recognition on the North Carolina Division of Public Health, Nutrition Services Branch website. Engage stakeholders, including hospitals and maternity centers, to solicit feedback during the development/adaptation of the program and to create buy-in for the program. Create or adapt standards, designation levels, a program application, and logo for the program, based on state or regional needs. Assemble a review team that is knowledgeable in quality improvement, breastfeeding and the Ten Steps to Successful Breastfeeding. Develop and implement a selection process for designation. Distribute and make the program application available to hospitals and maternity centers. Publicize the program through media outlets. Provide a designation packet to all hospitals and maternity centers awarded designation. Provide technical assistance and feedback to hospitals and maternity centers that express interest in the program, apply for the designation and/or are awarded designation.