The World Health Organization recommends honey as a nighttime treatment for coughing in young children with URIs.
In the current study, children with URIs and nocturnal cough were given either 1 of 3 different honey products or a placebo 30 minutes before bedtime, based on a double-blind randomization plan. The primary outcome evaluated was a subjective change in cough frequency, based on parent surveys. Secondary outcomes measured included a change in cough severity, the effect of the cough on sleep for both the child and the parent, and the combined score on the pre- and postintervention surveys.
Herman Avner Cohen, MD, from the Pediatric Ambulatory Community Clinic, Petach Tikva, Israel, and colleagues compared symptom scores for each treatment group before and after the intervention and found that patients in all 3 honey groups demonstrated significant improvement compared with patients treated with placebo. There were no significant differences among the different types of honey.
“The results of this study demonstrate that each of the 3 types of honey (eucalyptus, citrus, and labiatae) was more effective than the placebo for the treatment of all of the outcomes related to nocturnal cough, child sleep, and parental sleep,” the authors write.
The researchers enrolled 300 children with URIs, aged 1 to 5 years, who were seen at 1 of 6 general pediatric community clinics between January 2009 and December 2009. Patients were eligible if they had a nocturnal cough attributed to the URI. Children were excluded if they had symptoms of asthma, pneumonia, laryngotracheobronchitis, sinusitis, and/or allergic rhinitis. Patients who used any cough or cold medication or honey in the previous 24 hours were also excluded.
Parents were asked to evaluate the children the day of presentation, when no medication had been given, and then again the day after a single dose of 10 g of eucalyptus honey, citrus honey, labiatae honey, or placebo (silan date extract) had been administered before bedtime. Pre- and postintervention subjective assessments were obtained using a 5-item Likert-scale questionnaire regarding the child’s cough and sleep difficulty. Only those children whose parents rated severity as at least a 3 (on a 7-point scale) for at least 2 of the 3 questions related to nocturnal cough and sleep quality on the preintervention questionnaire were included.
Of the 300 patients enrolled, 270 (89.7%) completed the single-night study. The median age of these children was 29 months (range, 12 – 71 months). There was no significant age difference among the treatment groups. Symptom severity was also similar among all 4 treatment groups.
Adverse events were reported for 5 patients and included stomachache, nausea, and vomiting and were not significantly different between the groups.