Breastfeeding Medicine Consultation
Lisa Kahikina, MD, IBCLC
Physician-Owned Practice
Board-Certified by the American Board of Pediatrics.
International Board Certification Lactation Consultant (IBCLC)
Our practice is unique, as it is the only breastfeeding medicine practice in the State of Hawaii, that is operated and owned by a board certified lactation consultant, and a board-certified pediatrician. We specialize in comprehensive evaluations, which include an oral functional assessment of the baby. The ability to provide a complete oral functional assessment of the baby is beyond the scope of traditional lactation specialists, and has required extensive training. Dr. Lisa Kahikina also has additional training in functional medicine and nutrition to address common medical issues in both mother and infant, through the power of nutrition. Together, this expertise provides an assessment and breastfeeding plan that is often more extensive than a traditional lactation consultation experience.
Our breastfeeding medicine team is expanding!
More opportunities to meet your individual needs
Dr. Lisa Kahikina shown above with her family.
Our IBCLC specialists: Aly Certo RN, Jodie Dresel RN, Elizabeth Larrabee RN (at this time, no longer practicing with us). Professional Breast Massage Therapist: Ikuko Harada.
-We are a consultation service only. We do not see pediatric patients for primary care services.
-Insurance coverage and a referral from a provider is needed to access our services. You will only be allowed to access our providers after insurance coverage is verified. We participate with most major insurances in Hawaii, except for UHA. For UHA patients, call or message us for further information on how you can be seen by our services. If you are unsure whether your insurance covers your visit, call our office or send us a text through Klara to learn more.
-You will need a referral from either your OB/GYN or your baby’s pediatrician. Most OB/pediatric physicians in Hawaii, especially on the island of O’ahu, are aware of our referral process, but should your provider need further assistance for your referral, please click on the physician referral button below. We provide in-person and telehealth services for all patients on O’ahu. We provide telehealth services for all outer island patients.
The start to a healthy life: it's more than just the milk...
Whether you feel you will struggle with breast-feeding or not, or whether you feel you are struggling with breast-feeding or not, the best way to be prepared is to plug-in to a support network. Schedule an appointment with our office for your baby's visit, and receive on-going breast-feeding support when you need it.
Whether you are pregnant with multiples and want to prepare for your breastfeeding experience, or currently breastfeeding multiples - we can support your breastfeeding needs.
Think a stroller is one of the must-have baby gear? Think again! Join the baby-wearing movement. Not only will you improve breastfeeding, but you will provide an amazing way to grow your child's brain through carrying your child as much as possible, especially in the first year of life!
Often mothers are not aware of the challenges they will face when they embark on the journey of nursing their child. Images every where, on the internet, on social media, on television and movies, make breastfeeding seem so easy. You just pop the baby on the breast, and nature takes care of the rest, right? When it doesn't happen that easily, many women blame themselves. They feel guilty that they can't seem to get it right. They worry that there is something wrong with them. They think that their baby just doesn't like their milk, or that their baby just doesn't want to nurse. But that is rarely, if ever, true.
Fathers play an important role in raising a newborn baby. It's amazing how a well-involved father can greatly improve mother's success with breast-feeding. Fathers are welcome, and encouraged, to attend lactation visits with mother and baby.
Did you know...
...Colostrum is produced in pregnancy. Therefore mom has colostrum for baby's first feeding session, immediately after birth. Therefore stimulation by an effectively feeding baby is not necessary for mother to have colostrum for the first 24-48 hours after delivery.
...Breast milk "comes in" typically by Day 3-5. If a baby does not nurse effectively, meaning adequate seal and suction, both baby and mother can run into problems. Such problems for babies mainly center around excessive weight-loss and excessive jaundice. Problems for mothers include painful latches, engorgement and mastitis. Often it may seem that there is no problem with how a baby nurses in the hospital, but when the milk starts to come in, it begins to unmask underlying difficulties that may arise for mothers and babies.
...Many babies need assistance with latching, since their desire to self-latch can sometimes actually cause trauma to the mother. Learning to assist your babies with latching is a skill that mothers often need to practice in order to eventually nurse their babies easily and well. Mothers often need to practice the skill of assisting their babies to latch correctly to ensure adequate milk extraction and minimize mothers' pain. Having lactation support early to review mother's latching skills, can ensure a smooth transition towards successful breastfeeding.
...Mothers have many different breast and nipple anatomies, and babies sometimes come with their own oral (mouth) challenges as well. These differences do not predict whether a baby will or should nurse well. It's the combination of mother's breast and nipple anatomy, as well as baby's oral anatomy, that can affect how smoothly the nursing experience goes. Just because everyone you know can breast-feed well, and you are struggling, doesn't mean that you cannot breast-feed. And just because no one you know has been able to breast-feed, doesn't mean that you cannot. Appropriate support, adequate assessments of both you and baby, can give you the tools you need to be successful at breast-feeding. By having a full assessment of both mother and baby, you can better get a sense of whether the breast-feeding challenges you are facing are ones that could be overcome with appropriate support.
Learn what to expect when breastfeeding before your baby comes. Click on the link below from Stanford Medical to view their breastfeeding resources.
Is a tongue-tie the reason my baby is having a breastfeeding problem?
The short answer is: sometimes, but not always.
How our practice assess whether your baby’s tongue-tie is leading to breastfeeding problems for you and your baby:
Oral evaluation: This includes a TABBY assessment, a suck evaluation, a latching evaluation, and a weighted feed (milk transfer measurement). It is ALL of these evaluations TOGETHER, that helps us assess whether or not treating a tongue-tie will improve the breastfeeding problems you are experiencing.
Learn more about the TABBY assessment here: https://internationalbreastfeedingjournal.biomedcentral.com/track/pdf/10.1186/s13006-019-0224-y.pdf
Repeat visits: As babies mature, what may have seemed to be a problem before, improves over time. We use time to assess whether the baby is progressing and improving as expected, or not. If the baby is not improving as expected, then we may revisit whether treating a tongue-tie may be beneficial for your baby’s breastfeeding journey.
Improving milk supply: Sometimes improving a mother’s milk flow can treat many of the breastfeeding problems that a mom may be experiencing and contributing to a tongue-tie problem.
Body work exercises and suck training therapy: Our specialists are sometimes able to improve nursing, without treating a tongue-tie, by teaching you exercises that you can do at home with your baby, that loosens up any tightness in your baby’s body, as well as strengthens the muscles needed for producing an effective suction at the breast.