Role of honey in children with acute cough in upper respiratory tract infection: randomized, placebo-controlled study

Cough is an important defensive reflex that enhances the clearance of secretions and particles from the airways and helps to protect the lower airways from the aspiration of foreign material.1 It can be of infectious origin i.e. bacterial or viral and/or due to irritant or allergen in the respiratory tract.2 Acute cough in majority of children is from Upper Respiratory Tract Infection (URTI) i.e. common cold. Hallmarks of the common cold include runny nose, cough, and congestion. Mostly cough from acute URTIs are due to viral infections.3 Cough can be distressing for parents especially when it interferes with child’s daily activities and disturb parents and child’s sleep. It also results in absenteeism from school. As it is a major concern for parents, it is the most common presenting symptom to the general practitioners.4 Though an immediate remedy is usually sought by the caregiver, there is no effective treatment beyond ordinary supportive care. American Academy of Pediatrics (AAP) strongly recommends against the use of over-the-counter cough and cold medications in infants and children below two years of age. It also highlights that cold and cough products do not work in children younger than 6 years and can have potentially serious side effects.5 The World Health Organization (WHO) has noted honey as a potential treatment of cough and cold symptoms, and it is considered as a demulcent that is inexpensive, popular, and safe(outside of the infant population).6 The objective of this trial was to compare the effects of a single nocturnal dose of honey to placebo on nocturnal cough and the sleep difficulty associated with URTI.