12/17/2024
Cough — Cough may affect the child's sleep, school performance, and ability to play; it also may disturb the sleep of other family members and be disruptive in the classroom. Although caregivers frequently seek interventions to suppress cough, they should understand that cough clears secretions from the respiratory tract and suppression of cough may result in retention of secretions and potentially harmful airway obstruction.
We suggest that airway irritation contributing to cough be relieved with oral hydration, warm fluids (eg, tea, chicken soup), honey (in children older than one year), or cough lozenges or hard candy (in children in whom they are not an aspiration risk) rather than OTC or prescription antitussives, antihistamines, expectorants, or mucolytics. Fluids, honey, cough lozenges, and hard candy are inexpensive and unlikely to be harmful, although they may provide only placebo effect.
●Oral hydration and warm fluids are discussed above.
●Honey – We suggest honey as an option for treating cough in children ≥1 year with the common cold. The honey (2.5 to 5 mL [0.5 to 1 teaspoon]) can be given straight or diluted in liquid (eg, tea, juice.) Corn syrup may be substituted if honey is not available. Honey has a modest beneficial effect on nocturnal cough and is unlikely to be harmful in children older than one year of age. Honey should be avoided in children younger than one year because of the risk of botulism.
A meta-analysis of 14 randomized trials comparing honey with other interventions in children and adults with upper respiratory tract infections concluded that honey was superior to usual care (eg, placebo, diphenhydramine, dextromethorphan). Honey reduced cough frequency (standard mean difference [SMD] -0.36, 95% CI -0.50 to -0.21; eight trials, 832 participants) and cough severity (SMD -0. 44, 95% CI -0.64 to -0.25; five trials, 598 participants). In direct comparisons, honey was more effective than diphenhydramine and similarly effective to dextromethorphan in reducing cough frequency and severity. Adverse effects were uncommon and mild (eg, nausea).
Given the relative safety and low cost of honey, the World Health Organization (WHO) and American Academy of Pediatrics (AAP) suggest it as a potential treatment for URI in young children who are older than one year. The American College of Chest Physicians suggests that honey is more effective than placebo for cough due to the common cold
-up to date research