Hawaiʻi creeper is able to climb up and down trees. It uses its short, sharp beak to probe bark for insects residing underneath. If available, it will sip nectar from koa ("Acacia koa") or ōhia lehua ("Metrosideros polymorpha"). The breeding season of the Hawaii creeper lasts from April to July, during which female birds lay one to three eggs. Nests are hidden in a tree cavity or built on a high branch in either a koa ("Acacia koa") or a ōhia lehua ("Metrosideros polymorpha"). Eggs hatch after around thirteen days. The Hawaii creeper was put on the endangered species list in 1975;
Nin Jiom Pei Pa Koa in 1962, and continue to manufacture and sell the product worldwide. "Pei pa koa" had annual sales of HK$350 million in 2014. A study at the China Academy of Traditional Chinese Medicine published in a 1994 article, "Pharmacological studies of nin jion pei pa koa", states that Nin Jiom Pei Pa Koa had significant cough relieving and sputum removing effects. In four acute or sub-acute inflammatory models, the anti-inflammatory effect was marked.." "Pei pa koa" is made up of a blend of herbal ingredients including the fritillary bulb ("Bulbus fritillariae cirrhosae", 川貝母), loquat leaf ("Eriobotrya japonica", 枇鈀葉), ladybell root ("Adenophora