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Cough in kids is a common concern for parents and accounts for a large number of visits to the physician. Cough may be acute, chronic or mainly only occur during sleep. The causative factors involved are numerous and diverse and include gastroesophageal reflux disease or GERD and upper respiratory infections.
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A 2008 Cochrane Database Review concluded that scientific evidence supporting role for cough suppressants in kids 2-7 years is of doubtful clinical significance. A similar article was published in the British Journal of General Practice with the title, "Over-the-counter cough medicines in children: neither safe or efficacious?"
Honey has been used as a household remedy for cough since ancient times. In India, Honey (25%) and Ginger (27%) are the most common home remedies for cough by mothers.
But does honey really work against cough?
Previous Honey-cough Studies
- Paul and colleagues compared buckwheat honey to dextromethorphan versus no treatment and found buckwheat honey to be superior for decreasing severity and frequency of cough with improved sleep for treatment of nocturnal cough in kids.
- Shadkam et al reported that honey is superior to dextromethorphan as well as diphenhydramine (eg Benadryl) for treatment of nightly cough.
Study overview
Dr. Oduwole and colleagues from the Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital (ITDR/P), Calabar, Nigeria conducted a meta-analysis and systematic review of scientific literature dealing with effect of honey on acute cough in kids. The results of the study were published in the Cochrane Database Systematic Reviews March 2012.
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Design of honey-cough study
- Analysis of randomized controlled trials involving the use of honey as a therapy for acute cough in comparison to or in combination with antibiotics, versus nothing, placebo or other over-the-counter cough medications to children aged two to 18 years.
- Screened studies were examined for eligibility: Data was then extracted to analyzed
- Two randomized controlled studies of high risk of bias met the inclusion criteria
- 265 kids were included
- Improvement of cough was measured utilizing a 7-point Likert scale.
Results of honey-cough study
- Honey is superior to 'no treatment' in reducing cough
- Honey is similar in efficacy to commonly used OTC cough suppressant dextromethorphan
- Honey offered superior scores better than diphenhydramine (Benadryl®) in reducing cough
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Side-effects
Mild side-effects were seen in 9.3% kids in the honey group but the difference was not statistically significant as compared to dextromethorphan or diphenhydramine group.
Dr. Minocha's comments on role of honey in acute cough
- Honey is superior to 'no treatment' and diphenhydramine (Benadryl®) but not better than dextromethorphan for relief of cough in kids.
- As far as cough associated with upper respiratory infections in kids is concerned, Dr. Paul at the Departments of Pediatrics and Public Health Sciences, Penn State College of Medicine (as reported in the journal LUNG)has concluded that there is lack of well-designed studies supporting role for use of narcotics (codeine, hydrocodone) and FDA approved over-the-counter (OTC) cough suppressants and expectorants like dextromethorphan, diphenhydramine, chlophedianol, and guaifenesin. In such cases, honey may be a viable alternative.
- Cough suppressants are not effective in kids below the age of 6 years and probably not effective for kids of any age.
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Dr. Minocha's comments on honey in general:
- Not all honey is the same. In general. food honey is as effective as medicinal honey beyond the first year of life and usually cheaper! Effective types of honey include eucalyptus honey, citrus honey, and labiatae honey. Each dose is 5-10 g.
- While it is contrary to practices in many Eastern cultures, honey is not recommended for use in kids below the age of 1 year because of risk for infantile botulism.
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