How Much Dark Honey for Cough?

Nighttime cough is rough for kids and for parents. I’m not surprised that people spend billions of dollars on over-the-counter cough remedies, even though the most common ingredient, dextromethorphan (DM), has not been shown to be more helpful for kids than placebo. Now that the American Academy of Pediatrics and an FDA advisory panel have come out against the use of DM in kids under age 6, because of side effects, what’s a parent to do? It would be nice to have something that decreased both the frequency and severity of nighttime cough and increased sleep for both kids and parents. According to a study of kids from age 2 to 18 published in the December 2007 Archives of Pediatrics and Adolescent Medicine, honey may be one great solution. The children in the study had come into an acute care clinic with colds and coughs that had kept them (and their parents) up the night before. About one third randomly received artificially-honey-flavored DM cough syrups, about one third received real buckwheat honey, and about one third were given no treatment. In a three-way comparison, the honey scored the best in every category: reducing the number of coughs, reducing the severity of coughs, reducing the bother of coughs, increasing sleep for kids, increased sleep for parents, and combined symptom score. In two-way comparisons, only honey was significantly better than no treatment at all. The dose was ½ tsp in a single dose 30 minutes before bed for kids 2 to 5, a full tsp for kids 6 to 11, and two teaspoons for kids 12 to 18. The authors suggest choosing darker honeys as they contain more bioactive compounds. The study was done in Hershey, PA, reminding me that chocolate contains another remedy studied for coughs that proved better than DM. Given that DM can cause neurological side effects even at the appropriate dose, I’m a fan of trying gentle, food-based remedies like these.

Alan Greene MD FAAP

Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, and Berlin CM. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Archives of Pediatrics and Adolescent Medicine. 2007. 161:1140-1146.

Note: The authors of the study report that they were funded by the National Honey Board, an industry-funded agency of the USDA, who were not involved in study design or data analysis. The lead author has also been a consultant to Mcneil Consumer Healthcare, which makes cough/cold medicines for children.