Self-treatment of cough with remedies of which honey is one is common. Except in infancy, honey has been shown to be a useful, inexpensive, readily available and safe substance for children. In fact, honey calms coughs better than cough medicine in children.
Researchers, in a 2023 review to update evidence on effectiveness of honey for cough, said honey may be more effective than no treatment or over-the-counter medications for acute symptom relief in cough. It was in the European Journal of Pediatrics.
According to them, based on low quality evidence, honey seemed to decrease cough frequency more than no treatment and cough medication. Also, sleep improved more often in the honey group compared to no treatment or cough medication group.
Cough is among the most common symptoms in children and it is mostly caused by upper respiratory tract infections (URTIs). Coughing, especially during sleep, can be particularly troubling to children and their parents, as it often results in discomfort to the child and loss of sleep for both the child and its parents.
Cough is a major cause of outpatient visits because it can impact quality of life, cause anxiety and affect sleep in children and their parents; thus, effective treatments are needed.
Cough medicines and syrups have not been effective in children and have also been associated with severe harm. Nowadays, the use of cough medication is not recommended and many guidelines prohibit the use of such products in children less than one year.
Honey has been examined in several randomised controlled trials, but the results varied. The latest systematic reviews published in 2018 and 2021 stated that honey is an effective treatment for cough and causes no severe harm; therefore, it could be used to treat acute cough.
The systematic review in 2021 included both adults and children and concluded that honey is an effective alternative to antibiotics in the treatment of acute cough, though its efficacy was not compared to antibiotics. Acute cough is typically classified as cough lasting less than 4 weeks.
Prior randomised trials have had conflicting results and thus an overview of the literature was warranted.
The researchers declared, “Although we did not perform meta-analysis, the systematic review of the range of observed effects indicated indirectly that honey would be more effective than placebo/no treatment and cough medication.
“Interestingly, the most recent meta-analysis, which included adults, stated that honey could be an alternative to antibiotics, but we were unable to find a single study in which antibiotics would have been the comparator group.
“The conclusion that can be made based on their analysis and the current report is that honey may be effective in reducing symptoms in children suffering from acute cough. Unfortunately, the quality of the reporting of adverse effects was low. It seems that honey may have a higher possibility of causing adverse events than placebo/no treatment.
“Based on our results, no sufficient comparison between honey and cough medication can be made. However, this is not a limitation as, generally, the use of cough medications should be avoided in children.
“Based on our results, it seems feasible to tell the parents that honey is a possible and likely effective treatment for acute cough but it may cause some adverse reactions (mainly vomiting or nausea).
“Future randomised studies with a double-blinded, placebo-controlled design are needed to determine the effectiveness of honey and the rate of adverse events before it is possible to make stronger recommendations for clinical practice.”
Now, the current screened 396 papers and 10 studies were included. Two studies had high risk-of-bias and six had some concerns. These were studies conducted in children ranging between one and 18 years. Animal studies were excluded. Observational studies and all other studies not presenting original data were excluded.
Ten studies measured cough frequency. Seven studies compared cough frequency between honey and placebo/no treatment and five studies compared cough frequency between honey and cough medication.
Ten studies measured the quality of a child’s sleep. Seven studies measured adverse events, which mostly included nausea and vomiting.
For instance, a single-blind randomised control trial involving children presenting with cough from URTI attending the GOPC of Federal Medical Centre, Keffi, Nasarawa State. Eighty-four children were recruited and randomised into two groups of 42 and administered honey (intervention) and Diphenhydramine (control) in three consecutive bedtime doses.
In the study, published in the West African Journal of Medicine, cough and frequency severity decreased, post intervention pooled caregivers’ burden significantly reduced and sleep pattern improved among children and caregivers, for children and caregivers respectively in the two groups.
It said: “Night-time honey doses given to children with cough from Upper Respiratory Tract Infection (URTI) significantly reduced symptoms and improve children and caregivers sleep, compared to Diphenhydramine DPH, the common cough suppressant in many over-the-counter cough medicines.”
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