Honey for cough in children

by James Hubbard, M.D., M.P.H.

If we are not supposed to give cold medicines to kids anymore, then what is a parent to do?

Is honey the answer? With good timing a study came out in the December 2007 Archives of Pediatric and Adolescent Medicine showing that buckwheat honey is more effective than dextromethorphan (dm) in cough in children 2 and over.

Following are the tested doses given 30 min before bedtime:
–ages 2-5: 1/2 teaspoon
–ages 6-11: 1 teaspoon
–ages 12-18: 2 teaspoons
A cup of uncaffeinated beverage could be given with this if wanted.

Another group was given dextromethorphan as directed from the label. A third group was given no cough suppressant. The parents rated the honey the best regarding cough, child sleep and parent sleep.

The study used buckwheat honey because it is a dark variety with more antioxidants. They surmise that the antioxidants might play a role in suppressing the cough. It was also suggested that the sweetness of the syrups may trigger a cough suppressant chemicals in the body.

The AAP recommends staying well hydrated with fluids, using humidifiers, using saline nose drops and bulb syringes for stuffy noses, treating underlying problems such as asthma, and avoiding aggravates such as allergens, smoke, etc.

As mentioned in our QuickBlog on 1/18/08, the FDA has advised not giving cold medicines to children under 2 years old due to the potential of serious side-effects. The FDA has not finished its review for children 2-11.

The American Academy of Pediatrics (AAP) added to this by reaffirming that there is no evidence that codeine or dextromathorphan (found in many over-the-counter cough meds) is beneficial to children..

What do you think about the recommendations? Have you tried honey?

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5 Responses to “Honey for cough in children”

  1. Sandy Richardson Says:

    I’m not sure where I orignially heard that babies (under 1yr) are not supposed to be given honey? Is this an old wives tale? I would certainly like to try this with my 3 yr old as the cough medicine seems to make the cough worse at night.

  2. jhubbard Says:

    Sandy, there is definite cause for your concern. Several studies have found that botulism, a very serious disease, can occur in infants under 1 year old that have eaten even small amounts of honey. The studes have been across the globe. The latest that I can find consists of some cases reported by the New York health Dept in 2001-2002.

    Honey can be contaminated with some hard-to-kill “botulin spores.” These spores can germinate into the botulism bacteria. The amount of spores is very small. From case-reports, the spores do not seem to effect anyone over 1 year old. In fact, 95% of the botulism is found in babies under 6 months of age. Apparently it has something to do with the immaturity of the baby’s intestinal tract. I wonder if it might also be due to the bacterial concentration being larger to baby’s smaller relative size.

    Bottom line is never give even small amounts of honey to children under one year of age. After that, it appears safe and healthy. (see original post for dosing.)

    -Dr. Hubbard
    -4/29/08

  3. Dr.Cason Says:

    I saw two cases of infant botulism in residency and completely agree with Dr. Hubbard! It was a scary site and one that we’d do best to avoid.

    On the other hand, I give this honey advice to my parents of older kids a lot and find they are very grateful to know there is an alternative!

  4. James Hubbard, M.D., M.P.H Says:

    Yes, I think it is important to make the distinction–Don’t give honey to children under age 1, OK in the older kids and adults.

  5. James Hubbard’s My Family Doctor Blog » Blog Archive » Children under 6 should not take over-the-counter cough and cold medications Says:

    [...] treated (if needed) try increasing humidity with oral fluids and a humidifier. You could give honey as suggested in a former blog, since it has been found more effective than the otc’s any… Just don’t give the honey to children under 1 (see the “honey blog” [...]

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