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Honey: cough in children with URTI

Intervention

Short-term use of honey for cough in children with an upper respiratory tract infection (URTI).

Indication

In general, cough associated with an URTI in children does not require treatment; however, treatment may be necessary when the cough interferes with sleep.

Honey may be used if a cough suppressant is sought for the short-term symptomatic relief of nocturnal cough in children (12 months to 18 years of age) with an URTI after other causes of the cough have been excluded (eg asthma, pneumonia, chronic cough).

Considerations

Honey is preferred to over-the-counter cough and cold medications for children older than 12 months of age with cough due to an URTI.

A 2014 Cochrane Review concluded that honey was better than ‘no treatment’ or placebo in reducing the frequency of cough in children. It was also found to be superior to  diphenhydramine (low-quality evidence) and no significant difference when compared to dextromethorphan (medium-quality evidence).

Cough and cold medications are subject to accidental overdose and can cause serious adverse reactions in children. Honey would seem to be a less risky alternative.

(Note that, in Australia, over-the-counter cough and cold medicines are not recommended for children under 6 years of age.)

Precautions

With prolonged use, honey is likely to be harmful to teeth. Consequently, prolonged use of honey for treating cough is not recommended.

Contraindications

Honey is not recommended for children younger than 12 months of age. It has not been tested for cough in this population and there are concerns about a risk of botulism from some honey products.

Adverse Effects

Botulism has been reported in children younger than 12 months of age after consuming honey; hence honey is contraindicated in this age group.

Availability

Honey is relatively inexpensive compared with medicinal products. It can be purchased at any supermarket or health store.

Description

0.5–2 teaspoons (2.5–10 g) of honey is given to the child at bedtime.

Any variety of honey can probably be used, so pick a variety that the child likes. (Although not all varieties of honey have been tested, a comparison of three different types of honey – eucalyptus, citrus and labiatae honey – found no difference in efficacy between the three varieties.)

Tips

The honey dose can be given in a drink such as warm water.

Honey can also be tried for symptomatic relief of daytime cough due to an URTI.

Make parents aware that coughing helps clear mucus from lungs. The cough should disappear with no treatment as the infection clears. Honey provides symptom relief only. It does not cure the underlying infection.

Grading

NHMRC Level I evidence.

References

First published: October 2014

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