Source: ABC Everyday
In certain culture, parents have given coughing children a spoonful of honey at bedtime to ease their cough so everyone can get some sleep.. And while most children are more than happy with this treatment, is there any evidence to suggest this approach works?
Ronald McCoy, from the Royal Australian College of General Practitioners (RACGP), says there is some research showing a spoonful of honey every few hours can reduce irritation in young throats.
“The World Health Organisation recommends honey for coughs in developing countries where there’s limited access to medication,” Dr McCoy says.
“So although the evidence isn’t strong, it suggests there may be an effect in acute coughs in children.”
Honey at night worth a try
In a 2012 study, 300 children were assigned to one of four different night-time cough treatments: three were different types of honey and the fourth was a placebo.
Researchers found any one of the three types of honey was more effective at treating night-time coughing than the placebo.
A 2014 study showed a single dose of half a teaspoon of honey before bedtime diminished coughing and the discomfort experienced by children and their parents. Dr McCoy says newer studies suggest administering a few daily doses, but this practice will need further study. It’s unclear how effective honey is in terms of relieving coughs in adults, says paediatric respiratory and sleep physician Anne Chang. But she says as long as someone doesn’t have other illnesses where they should be avoiding honey, such as diabetes, it won’t hurt to try.
“An adult will require higher doses and increased frequency [so] I’d encourage using honey in lemon drinks, rather than taking spoonfuls of it,” Professor Chang advises.
How honey helps a niggling cough
It’s not clear exactly how honey eases a cough. The authors of the 2012 study noted honey contains more than 181 different natural substances and suggested its antioxidant and antimicrobial properties may explain why it helps relieve children’s coughs. Professor Chang says while honey does contain microbial properties, it’s probably a combination of elements that make it effective.
“In addition to honey coating the throat and triggering the swallowing mechanism, its sweetness likely changes the sensitivity of sensory fibres,” she says.
“There’s an interaction between the sensory nerves locally and those in the central nervous system that are involved in the regulation of the mechanism of cough.”
More effective than cough medications
The RACGP says honey is preferred to over-the-counter cough suppressants to relieve symptoms of night-time coughing in a child over 12 months old with a cold. General practitioner Brian Morton says trials have shown many over-the-counter treatments don’t work and can also cause adverse reactions.
“Some of the ingredients, when used several days in a row, can have adverse effects,” Dr Morton says.
These adverse effects could include allergic reactions, drowsiness, nausea and shallow breathing. Evidence showing potential harm and lack of benefits prompted Australia’s medicines regulator, the Therapeutic Goods Association (TGA), to recommend children under six should not be given cough and cold medications sold over the counter. For children aged between 6 and 11, the recommendation is to give the medications only on the advice of a medical practitioner. Dr Morton points out that honey, like other medications, only treats the symptoms. “Not a lot can really shorten the course of an infection once you have it,” he explains. But before opening the honey jar, you should see your GP to rule out other causes of the cough, such as asthma, pneumonia, or chronic cough.
Honey not recommended for babies
It is important to note, Dr McCoy says parents shouldn’t give honey to children under 12 months old — whether they have a cough or not. This is because honey can be a source of botulism spores and, as Dr McCoy says, “there’s the risk of infant botulism, which is extremely rare, but the child’s immune system won’t be developed enough [to fight it off]”. Instead, he recommends giving babies lots of cuddles, small amounts of fluid regularly, and taking them to the GP if necessary.
Coughing helps move secretions
Although it might be difficult for exhausted parents, Professor Chang says an alternative to treating a child’s cough is not to do anything.
“The reason kids cough is to move secretions upwards, so it’s actually a defence mechanism,” she explains.
“But some kids become more stressed than others and it affects parents’ sleep.
“Other alternatives, besides honey, that won’t cause harm are to use a menthol-based ointment on the chest, and gently pat the child on the back.”
So yes, honey can be a safe and natural treatment for temporary relief from coughing — in moderation. This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.
This story, which was originally written by Cassie White and published by ABC Health and Wellbeing, was updated in 2019.