Pregnancy, birth, breastfeeding, and postpartum recovery are important times of physical, emotional, spiritual, and ʻohana connection. This guide brings together ʻike kupuna, Native Hawaiian cultural practices, and current health information to support makuahine, keiki, and ʻohana.

HĀPAI • HĀNAU • HĀNAI WAIŪ 

A Native Hawaiian Maternal Health Guide

Pregnancy, birth, breastfeeding, and postpartum recovery are important times of physical, emotional, spiritual, and ʻohana connection. This guide brings together ʻike kupuna, Native Hawaiian cultural practices, and current health information to support makuahine, keiki, and ʻohana. 

A note about this guide: ʻIke kupuna and traditional practices are presented as cultural knowledge and historical practice. Some practices may not be appropriate or safe for every pregnancy or birth today. Talk with your OB-GYN, midwife, or other qualified health professional before using lāʻau lapaʻau, herbal preparations, supplements, medications, or physical techniques during pregnancy or labor. 

Data Informs the Work

Native Hawaiians and Pacific Islanders, compared to other racial groups, are the least likely to enter prenatal care early in their pregnancy, and they’re most likely to get no prenatal care.

This is what we know

    • Pregnancies that are Intended – In 2022, Native Hawaiians reported the lowest rate of pregnancies that were intended at 40%, as compared to the overall Hawaiʻi population at 60%. 
    • Women with Depression before Pregnancy – 11% of Native Hawaiian women reported having depression before pregnancy, as compared to 10.5% of the overall Hawaiʻi population 
    • Infant Mortality Rates – from 2022-2024, Infant mortality rates for Native Hawaiians were at 6.7%, which is higher than the overall Hawaiʻi value at 4.7% 
    • Breastfeeding stats for NH – In 2022, 55% of Native Hawaiians reported exclusively breastfeeding for 8+ weeks, as compared to 55% of the overall Hawaiʻi Population. 
    • 18% of teen pregnancies are among Native Hawaiians, as compared to 11% of the overall Hawaiʻi population 

Introduction:

From hāpai to hānau and into the early years of being a makua, maternal and child health is deeply connected to the well-being of the whole ʻohana. For Kānaka Maoli, pregnancy, birth, breastfeeding, and caregiving have long been grounded in pilina, with ʻāina, kūpuna, community, and the generations yet to come. These practices remind us that caring for mothers, birthing people, babies, and caregivers is not only clinical care; it is cultural, emotional, spiritual, and collective care.

Since Western contact, the health and birthing practices of Native Hawaiian ʻohana have been impacted by the loss of resources, changing systems of care, and barriers to culturally grounded support. Today, many Native Hawaiian ʻohana continue to navigate challenges related to access, affordability, respectful care, and trusted information throughout pregnancy, birth, postpartum recovery, infant feeding, and early childhood. These experiences are shaped not only by individual choices, but also by the environments, systems, and supports available to each ʻohana.

There are many ways to nurture healthy beginnings and strengthen ʻohana well-being. Early prenatal care, nourishing foods, safe and supported birth experiences, hānai waiū, emotional support, and connection to cultural practices can all contribute to the health of makua and keiki. This page offers information and resources organized by life stage: hāpai, hānau, and makua, to help families find support when they need it and feel more connected on their journey.

Papa Ola Lōkahi aligns its efforts with the recommendations outlined in the Native Hawaiian Health Care Act of 1988 and the E Ola Mau reports from 1985, 2019, and 2023. While the E Ola Mau reports do not contain a dedicated chapter on chronic health conditions or maternal child health, as these conditions often intersect with all aspects of health, they are referenced throughout various chapters and incorporated into the broader recommendations.

Hāpai | Pregnancy

ʻIke Kupuna | Cultural Knowledge 

Pregnancy was considered a sacred, formative period. The unborn child was considered a person whose character was already being shaped in the womb. A mother’s physical, emotional, and spiritual well-being was believed to influence her baby’s future health, temperament, and character.  

Makuahine were encouraged to cultivate: 

  • Calmness 
  • Kindness 
  • Patience 
  • Emotional steadiness 

Traditionally, mothers were encouraged to avoid anger, harsh speech, arguing, and other negative emotional states. These teachings reflected the belief that what surrounded and affected the mother also affected the keiki and could result in weakness, poor temperament or physical abnormalities. 

ʻIloli, or the discomforts of pregnancy, were understood as a normal part of hāpai. Changes in mood and anxiety were also recognized, with calmness, kindness, and relational care encouraged as forms of support. 

If the Kahuna wanted to find out the gender of the baby, he would sit down to talk with his patient and ask to see their hand. If the makuahine extended her right hand, the baby would be a boy; if it was her left hand, it would be a girl.  

Lāʻau Lapaʻau 

Traditional lāʻau lapaʻau supported the health and strength of makuahine and keiki. Kupuna, women, and experienced practitioners passed down this knowledge, and they accompanied it with pule. 

Important: Traditional plants, teas, oils, and preparations can have biological effects and may interact with medications or pregnancy. Do not assume they are safe just because they are natural. Discuss their use with a qualified practitioner and prenatal care provider. 

Modern Day Recommendations 

Caring for yourself and your keiki | Important Things to Consider 

During the first trimester: 

  • Schedule your first prenatal appointment with your OBGYN or midwife 
  • Take prenatal vitamins that contain folic acid 
    • Only 37.8% of Native Hawaiian people reported taking folic acid or vitamins prior to pregnancy, as compared to 50% of the overall Hawaiʻi population. 
  • Eat a variety of nutritious foods 
  • Stay active but know your limits (Recommended: 2.5 hours of moderate intensity activity each week)  
  • Drink plenty of water (Recommended: 8-12 cups per day) 
  • Get adequate rest (Recommended: 7-9 hours each night) 
  • Avoid alcohol, tobacco and other substances that can harm pregnancy 
  • Celebrate and connect with your growing keiki 
  • Make a dentist appointment 
    • Pregnancy is associated with increased risk for gum disease and tooth decay. Gum disease has been linked to an increased risk for low birthweight and preterm birth, and cavity-causing bacteria in the mother’s mouth can be transferred to her child before birth.   
    • Only 36.7% of Native Hawaiians got a teeth cleaning while they were pregnant, as compared to 47.5% of the overall Hawaiʻi population 

Your keiki’s development 

  • The neural tube forms and will become the baby’s brain and spinal cord 
  • Heart begins beating and can be detected on ultrasound 
  • Major organs begin to develop 
  • Tiny buds appear and turn into arms, legs, fingers, and toes 

Common First Trimester Symptoms 

You may experience: 

  • Missed period 
  • Extreme tiredness 
  • Tender or swollen breasts. Your nipples might also stick out. 
  • Upset stomach with or without throwing up (morning sickness) 
  • Food cravings or aversions  
  • Frequent urination 
  • Mood changes 
  • Mild cramping or pulling sensation 
  • Constipation 
  • Light spotting 
  • See other symptoms here

Managing Symptoms | Comfort Measures 

Morning sickness:  

  • Eat dry crackers or toast before getting out of bed. 
  • Eat small, more frequent meals so your ōpū doesn’t stay empty 
  • Drink ginger tea; try sour candies 
  • Avoid greasy, spicy, or strong-smelling foods. 

Fatigue:  

  • Take naps and get adequate sleep each night 
  • Keep your schedule light and ask for help 
  • If you have the energy, do light, gentle exercise 

Constipation + Bloating:  

  • Drink lots of water all day 
  • Eat high-fiber foods like fruits, vegetables, and whole grains.
  • Consider gentle laxatives (prunes or prune juice) or talk to your doctor about safe stool softeners 

Breast Tenderness: 

  • Wear a soft, wire-free bra 
  • Use cool or warm compresses for relief 

Bleeding and Spotting:

  • Wear a pad, keep track of blood flow (color, texture, presence of clots) 

Seek prompt medical attention if you experience: 

  • Excessive bleeding or spotting
  • Severe abdominal or pelvic pain
  • Severe nausea and vomiting  
  • High fever
  • Severe dizziness, blurred vision, or extreme weakness
  • Chest pain or difficulty breathing 

Trust your naʻau if something doesn’t feel right

Resource Links

ʻIke Kupuna | Cultural Knowledge 

Lomilomi was done daily and used as physical therapy and supportive care. 

Food was understood as formative medicine. Hoʻokauhua (cravings) were believed to have come from the baby and were therefore given attention, as they symbolized babies coming to nature. 

Traditional teachings also included symbolic practices surrounding pregnancy. For example, closed circular lei were avoided because of their association with umbilical cord entanglement, and open-ended lei were preferred. The same applied to working with cordage; makuahine were not allowed to stitch tapa because a kink in the cords was believed to cause a kink in the umbilical cord. 

No pregnant woman was allowed to string fish for drying, for if the fish spoiled, the baby would be born with a nose disease that affected the breath. 

Attention was given to resting positions and body alignment. 

 

Traditional Food Practices 

Around the fourth month of hāpai, the diet of the mother became more regulated and varied depending on the ʻāina. Moderation and balance were emphasized.  

Foods encouraged to eat included: 

  • Plenty of greens such as  pōpolo, āheahea, lūʻau and palula
  • Cooked fish
  • Balanced meals with moderate portions 

Foods that were limited or avoided: 

  • Overly salty food
  • Bitter or strongly flavored foods 
  • Large amounts of raw fish 
  • Excess starch and fat 

ʻŌlelo Noʻeau: “I paʻa ke kino o ke keiki i ka lāʻau” 

What the mother consumed was believed to shape the keiki physically and emotionally. Limited salt intake undoubtedly controlled fluid retention and may have prevented the toxemia and eclampsia sometimes associated with pregnancy and labor. 

Caring for Yourself and Your Keiki 

During the second trimester: 

  • Continue attending prenatal appointments
  • Begin preparing for baby’s arrival (crib, car seat, diapers, newborn clothing)
  • Invest in comfortable maternity clothes
  • Attend childbirth classes
  • Gather newborn essentials
  • Bond with your keiki (read books, play music, talk or sing to them!) 

Common Second Trimester Symptoms 

You may experience: 

  • Body aches, such as back, abdomen, groin, or thigh pain 
  • Stretch marks on your abdomen, breasts, thighs, or buttocks 
  • Darkening around your nipples 
  • A dark line from belly button to pubic area (linea nigra) 
  • Leg cramps 
  • Feeling your keikiʻs kicks/movements 
  • Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match both sides of the face. This is sometimes called the mask of pregnancy. 

Managing symptoms | Comfort Measures 

  • Back aches: Elevate feet while sitting, avoid standing in one position for too long, consider exercises for relief such as the “pelvic rock”, ask provider about prenatal stretches
  • Leg cramps: Consider taking a calcium supplement, stretch your leg with heels pointed while laying down to relieve cramps, stay hydrated
  • Stretch marks: Moisturize to reduce itchiness and appearance (common pregnancy-safe skincare options: cocoa butter, shea butter, vitamin E oils)
  • Other body aches: Wear supportive footwear, be mindful of posture, prenatal stretching and massages from someone trained in pregnancy care 

Trust your naʻau if something doesn’t feel right

Contact your health care provider immediately if you have: 

  • High blood pressure
  • Sudden or severe swelling of the face, hands, or feet
  • Premature contractions or severe abdominal pain
  • Vaginal bleeding
  • Severe headache or changes in vision
  • Clear fluid leaking from the vagina 

 

Your Keiki’s Development 

During the second trimester: 

  • Your keiki is growing rapidly 
  • Bones and muscles become stronger 
  • Kicks and flutters can be felt now 
  • Your baby begins responding to sounds 
  • The eyes develop and can open and react to light 

 

Resources/Links 

 

ʻIke Kupuna | Cultural Knowledge 

In the last trimester, makuahine traditionally received extra care and attention.  Ideally, a husband, mother, or another trusted member of the ʻohana would help protect the makuahineʻs energy and prepare her for birth. This period emphasized rest, nourishment, and emotional support. It was believed that “babying” the mother would better equip her to enter the desired symbiotic relationship with the baby after birth.  

By month 6, the mother was taught to eat lightly to prevent a “too-fat” baby. 

 

Lāʻau Lapaʻau 

Lāʻau lapaʻau (plant medicine) was used to support the makuahineʻs strength, comfort, and preparation for labor. Lāʻau use included plants, teas, oils, and topical preparations, always accompanied by pule. Knowledge was transmitted through kupuna, women and experienced practitioners. 

Teas/ingested lāʻau: 

  • koʻokoʻolau and akiahala tea was given to the mother to build the strength of the baby 
  • ʻIlima blossoms or the thick end of hau blossoms were eaten daily for two months prior to birth to provide lubrication during birth and to serve as a laxative, as no enemas were given
  • Pohuehue leaves rubbed over ōpū and eaten to hasten birth 

Topical applications: 

  • Kukui oil was rubbed on the stretched skin of breasts and ōpū to prevent swelling
  • Raw, dry kukui was mashed and wrapped in tapa, and rubbed over the makuahineʻs entire body for comfort  

Important: Do not use herbal preparations or attempt physical manipulation to change the baby’s position, start labor, or prepare the cervix without guidance from an appropriately qualified health professional. Some traditional practices may carry risks during pregnancy. 

Preparing Mind, Body and ʻOhana for Hānau 

Traditional teachings emphasized maintaining an open mind about the child and creating a peaceful environment for birth.  ʻAuʻau kai (to bathe in the sea)- mom would move her ōpū back and forth as she bathed in the ocean to loosen the baby so he would not stick during birth. Kahuna Pale Keiki (doctor for birth protection) would check if the baby was positioned properly. If correction was needed, a lomi with kukui oil gently manipulated the baby back into the right position.  Hoʻoponopono was done prior to or in early labor to resolve any grudges within the ʻohana. It was a way to clear obstacles and promote harmony, restore family aloha, and hoʻokuakahi (clear the way) for a safe delivery.  

Caring for Yourself and Your Keiki | Important Things to Consider 

During the third trimester: 

  • Attend routine prenatal checkups
  • Track your baby’s movements
  • Choose a pediatrician
  • Take birthing or prenatal classes
  • Tour the hospital or birth center 
  • Install your keikiʻs car seat
  • Know the signs of labor
  • Create a birth plan that outlines your preferences for labor, delivery, and newborn care  

Things to Pack in your Hospital Bag 

  • Photo ID
  • Insurance information
  • Prescription medications
  • Phone + charger
  • Comfortable clothing
  • Maternity underwear
  • Nursing bras and pads
  • Toiletries and personal items
  • Birth plan
  • Slippers or non-slip socks
  • Going-home outfit for baby 

Optional Items to Pack

  • Eye mask or earplugs
  • Personal pillow or blanket
  • Lip balm
  • Snacks or drinks
  • Soft music/headphones 

Common Third Trimester Symptoms 

You may experience: 

  • Shortness of breath
  • Heartburn 
  • Swelling of the ankles, feet, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.) 
  • Hemorrhoids 
  • Tender breasts, which may leak a watery pre-milk called colostrum (kuh-LOSS-struhm) 
  • Your piko may stick out 
  • Trouble sleeping 
  • Lightheadedness and dizziness
  • The baby “dropping”, or moving lower in your abdomen 
  • Braxton Hicks or labor contractions 

Managing Symptoms 

  • Heartburn: Avoid acidic foods, allow 60 minutes for food to digest before lying down, take calcium carbonate tablets (Tums) 
  • Swelling of the hands and feet: Elevate legs and feet to improve circulation. Avoid deep massage on the feet as this can trigger early labor.
  • Trouble sleeping or Insomnia: Get a pregnancy pillow for comfort, find a comfortable sleeping position, pre-sleep comfort activities (drinking hot tea, taking a warm bath)
  • Lightheadedness and dizziness: Avoid getting up too quickly, increase circulation with movement when standing for long periods of time
  • Shortness of Breath: Change to a position that helps you breathe easier, try breathing exercises, slow down movements 

Trust your naʻau if something doesn’t feel right

Contact your provider if you experience the following: 

  • Early contractions or indications of premature labor
  • Vaginal bleeding
  • High blood pressure
  • Severe headaches
  • Blurred vision
  • Shortness of breath, chest pain, or excessive swelling
  • Decreased or absent fetal movement 

Your Keikiʻs Development 

During the third trimester: 

  • Your keiki is gaining weight rapidly, with fat stores building under the skin to keep them warm after birth
  • Organs are maturing; lungs produce surfactant to help with breathing outside the womb
  • Baby will move into a head-down position in the uterus to prepare for delivery 

Resource Links

Hānau | Birth

Birth Support and Attendants 

Information sourced from Nānā I Ke Kumu vol 2 by Mary Kawena Pukui

Experienced women, including pale keiki, guided labor and delivery through practical care, reassurance, and birth protection. 

They provided: 

  • Physical support
  • Instruction
  • Reassurance
  • Positioning guidance 

Birth was women-centered and community-supported. 

Labor Movement, Positioning, and Touch 

As labor pains progressed, the mother was given a warm drink of hau tree bark to help make the pathway for the baby “slippery.” Cold water was forbidden. When labor pains began, the mother was encouraged to walk to and fro. Mother squatted or kneeled, sometimes putting her arms around the pale keiki’s neck; some held onto a rope hung from the roof beam. Layers of tapa mats were used under the mother so that if the baby slipped out, it would not hit the hard floor. Touch was practical and intentional, including rhythmic pressing and rubbing of the back and abdomen. When poha ka nalu (the amniotic sac) broke, they knew birth was near.

When she was ready to push, the koʻokua would sit behind her with arms wrapped tightly around her opu, and palpate during contractions as instructed by the pale keiki. In active labor, the mother was expected to endure her pain in silence. Screaming was disgraceful. Kahuna pale keiki would sometimes “transfer the pain” of labor to another, ho’okau ka eha. When the child is born, the pale keiki would proclaim “‘Ike ‘ia na maka i ke ao!” If the baby was firstborn, hiapo, sex was important: if it was a boy, the child would belong to the paternal grandparents; a girl would belong to the maternal ones.

The family member who functioned as the “OB” was sometimes the grandfather. His post-natal duties included sticking his finger (wrapped in tapa) into the baby’s mouth to remove the birth fluid, then rinsing his own mouth and suck out the fluid from the baby’s nose. He would then wipe the baby’s eyes clean. Mother’s ōpū was bound tightly with tapa and would continue to be bound until her bleeding stopped (during which time she remained isolated). 

Food and Hydration During Birth 

The emphasis remained on balanced nourishment, warmth, and avoidance of extremes during labor and birth. Cold water was forbidden during labor.

Lāʻau During Birth 

Plant medicine supported labor and strength, accompanied by pule (prayer). 

Administration forms: 

  • Teas
  • Washes
  • Topical applications 

Someone was sent to the beach to gather pōhuehue (morning glory), which was to help hasten the birth 

  • The number of leaves varied – but some kahuna asked for 8, others asked for 16 or 24, but it was always units of 4. The person who gathered the leaves picked half of the desired number with the right hand and offered a prayer to Kū; then they picked the other half with the left hand and offered a prayer to Hina. The two sets of leaves were kept separate; the ones in the right hand were to be eaten by the mother, and those in the left hand were crushed and rubbed over her abdomen.  

A mixture of Hau bark ōhia flowers, strained through coconut fiber with water, was drunk by the mother when labor pains were most severe. Warm broth of ‘ōhiʻa ‘ai (mountain apple) leaves and bark or kaunaʻoa pehu vine to help with expulsion of the ʻiēwe.

For vaginal tearing after birth, they would apply warm kukui nut oil, or juice from koʻoloa blossoms, palaʻa fern, or kūkaepuaʻa grass to the tears. A poultice of popolo leaves mixed with red paʻakai. Or the pale keiki would have mom sit over a vessel containing a steaming concoction of herbs.

After birth, the mother was given chicken or fish broth and greens to replenish her and help her expel excess blood.

Piko and ʻIēwe Protocols 

In 2006, a law was passed guaranteeing all parents in Hawai’i the right to take their ‘iewe home from the hospital (From Birth to Kanu, Kealopiko).

When the piko stopped pulsing, the pale keiki took a sharp piece of bamboo and cut 2 inches from the navel. It was tied with olona fibers, dusted with pia (arrowroot) starch to stop the bleeding, and wound tapa tightly around the opu. In some areas, the baby would not be bathed until the stump fell off. Later, when the mother’s milk came in, a little would be squirted in the baby’s eyes and around the piko. 

The piko was salted and wrapped up in kapa, or put in a bottle and carefully preserved among the treasures. When a suitable occasion arises, usually many years after the child is born, the piko is taken by the child’s makua to its final resting place and deposited in as secure a manner as possible (Hawaiian Customs and Beliefs Relating to Birth and Infancy, pg 236).

The piko was preserved, and family traditions varied on where it was placed, such as being buried, placed under rocks, or returned to the ocean. 

Critical birthing practice connecting Hawaiians to ‘āina is washing and planting of the placenta (Returning ʻŌiwi Birthing Practices to Hospitals in Hawaiʻi, 2024, pg 73)

Expelling of the ʻiēwe was helped along by lomilomi, hoʻokaomi (pressure) on the mother’s navel, gentle working of the poi pounder on the abdomen.  

The ʻiēwe was washed and buried in a meaningful place, spiritually anchoring the child to ʻāina and ancestry. Sometimes placed high in a hala tree. 

After burying the ʻiēwe, a tree was planted over the spot, and on no account was it to be cut down as long as the child lived (Hawaiian Customs and Beliefs Relating to Birth and Infancy, 1924, pg 234)

ʻIke Kupuna | Cultural Knowledge 

Nursing was normal and expected and began soon after birth. There was no substitute for motherʻs milk (waiū) in the olden days. Mothers nursed their own babies, or, if that was not possible, wet nurses were found.  

Frequent feeding was encouraged. 

There was no need to cover up or dismiss yourself from the public to feed the baby.  

Other nursing mothers could feed each other’s babies. 

Māwaewae- ceremony to ensure mother’s milk 

“to clear the way” 

A member of the family fetches a gourd full of spring water and a sweet potato vine about a foot and a half in length. The mother then stands at the door facing the rising sun, takes the potato vine and dips it into the calabash. Smiting herself with the vine on the right breast she says, “E, Kū, e! Ho mai a nui, a mapuna puna, a kahe a wai!” “O Kū, listen! I want milk for my baby; give me milk in abundance like a bubbling spring, flowing like water.” Again smiting herself on the left breast, she repeats the same (Hawaiian Customs and Beliefs Relating to Birth and Infancy, pg 241) 

Ukuhi- weaning ceremony 

Always began with pule, asking Kū and Hina to take away the childʻs desire for milk. A family member or kahuna set two stones (representing the motherʻs breasts) in front of the child and if they picked them up and threw them away, the ceremony was complete. It was always the babyʻs choice. 

Circumcision- the kahuna took water mixed with a little paʻakai, prayed to Kū, Kāne and Lono and that water became the tapu water of Kāne. The circumcision was performed and after, the kahuna wrapped white tapa around the babyʻs head and sprinkled him with water.  

Benefits of breastfeeding 

Breastmilk is the perfect nutrition for a baby and is the only thing a baby needs from birth to 6 months old. Breastmilk contains nutrients that help boost baby’s immune system so by breastfeeding you are helping protect them from infections, allergies, asthma, diabetes, obesity and cancer. Breastfeeding also offers benefits to makuahine by giving added protection from diseases like diabetes, cancer and osteoporosis. 

Newborns need to nurse frequently (about 10-12 times per day, and sometimes as often as every 20 minutes to 3 hours) and should not follow a feeding schedule. Some signs that baby is hungry include: 

  • Rooting (opening mouth) or hand sucking
  • Smacking lips or using tongue
  • Squirming, fussing, or searching for breast
  • Crying is often a late sign of hunger 

To learn more about feeding cues, visit this website: 

 

For tips on positioning and proper latching, see the following resources: 

  

Once your baby has latched, feed for as long as they are actively nursing (jaw moving and you can hear swallowing). When the nursing slows, try offering the other breast. Some babies will be full with just one breast at a feeding. 

How much milk should my baby drink? 

Your newborn’s stomach is very small at birth but will gradually expand over the first few days and weeks. Baby will be able to nurse a little more at each feeding but will still need to nurse frequently since breastmilk is digested easily and quickly.  

On Day 1, your newborn’s belly is about 1tsp or about the size of a grape. 

By day 3, baby’s belly is 1 ounce, or about the size of two kukui nuts 

In one week, your babyʻs belly is about 2oz, or about the size of a lime 

One month, babyʻs belly is about 3-4 oz, or about the size of a lilikoʻi. 

The more your baby nurses, the more milk your body will produce. Nursing frequently in those first few weeks will help to establish your milk supply. If you experience engorgement (fullness in breasts, often with discomfort), you may want to hand express or pump out some milk for relief. There are several different types of breast pumps available, some are handheld, and others are fully electric. You should also check with your medical insurance to see if a breast pump is covered under your plan, as many do offer them. Aloha Pumps is a local company that works with some insurance plans to provide breast pumps and other maternity essentials; see link below. 

Breast Care 

Hands were used gently on the breasts to: 

  • Encourage milk flow 
  • Ease fullness 
  • Prevent blockage 

Massage was intuitive and practical. 

Lāʻau and Supports for Milk 

Milk supply was supported through: 

  • Rest
  • Nourishment
  • Emotional calm 

Green papaya, ginger, and ʻolena (turmeric) contain natural chemicals that can help increase breast milk production. Green papaya is best eaten cooked. Add it to soups or stews and eat 1-2 bowls per day. Place fresh, sliced ginger in a pot with water and heat till boiling. Reduce heat then simmer 5-10 minutes. Enjoy 2-3 cups per day, hot or cold. ʻOlena can be used in cooking or made into tea. Fresh turmeric or turmeric powder (limit to 1 teaspoon daily) is recommended instead of turmeric supplements. Eating oatmeal, brown rice, and omega-3 fatty acids (found in fish, limu, and flaxseed) also help support healthy lactation. (https://kawaiola.news/columns/malama-i-kou-kino/support-hanai-poli-breastfeeding/  

 

Resources/Links 

Rest and Protection 

The mother entered a protected recovery period. 

She avoided: 

  • Heavy labor
  • Physical strain 

She was kept warm. 

Emotional quiet was encouraged. 

Healing was understood as both physical and spiritual. 

Postpartum Food 

Encouraged: 

  • Warm foods
  • Soft foods
  • Easily digestible meals
  • Broths
  • Simple preparations 

Avoided: 

  • Cold foods early in recovery
  • Sudden return to heavy meals 

Diet returned gradually to normal. 

The practice of ʻapuhala, a restorative drink given to the mother on the third and sixth days following birth. (Bringing Back Birthing Traditions, 2017, Ka Wai Ola) 

The ʻaha ʻāina māwaewae (clearing the way feast) was done within the first week after mom gave birth. It consisted of seafood, meat and root vegetables all with spiritual significance to “clear the way” for the newborn and help replenish the depleted nutrients in the mother. These foods being readily available was crucial to help a new mother heal her body and restore strength and energy (Pukui et al, 2014) 

Emotional Care 

While not using modern terminology such as postpartum depression, Chapter One of Nānā I Ke Kumu emphasizes: 

  • Emotional calm
  • Protection from stress
  • Avoidance of conflict
  • Support from experienced women
  • Quiet recovery environment 

These structures functioned as emotional safeguarding during postpartum recovery.  

Program Staff

  • Nāpua Casson-Fisher

    she/her/ʻo ia

    Director, Community Initiatives

  • Camille McComas

    Population Health Specialist - Behavioral Health, Substance Use & Recovery

  • Cathy Ferreira

    she/her/ʻo ia

    Administrative Support

  • Lilinoe Kauahikaua

    she/her/ʻo ia

    Education & Training Manager

  • Kawehi Moderow

    Population Health Specialist - Chronic Conditions, Maternal & Child Health, Sexual & Reproductive Health

  • Kuaiwi Laka Kahiwakapu Pili I Haupapanui Makua

    Population Health Specialist - Environmental Health, Nutrition & Oral Health

  • Ikaika Regidor

    ʻoia/they/he

    Program Manager, Community Initiatives

Contact

Kawehi Moderow, MPH

808-597-6550