Ian M. Paul, MD, MSc; Jessica Beiler, MPH; Amyee McMonagle, RN; Michele L. Shaffer, PhD; Laura Duda, MD; Cheston M. Berlin Jr, MD. Effect of honey, Dextromethorphan, and No Treatment on Nocturnal cough and sleep Quality for Coughing children and Their Parents. Arch Pediatr Adolesc Med. 2007;161(12):1140-1146.

Author Affiliations: Departments of Pediatrics (Drs Paul, Duda, and Berlin and Mss Beiler and McMonagle) and Public health Sciences (Drs Paul and Shaffer), College of medicine, Pennsylvania State University, Hershey.

Objectives To compare the effects of a single nocturnal dose of buckwheat honey or honey-flavored dextromethorphan (DM) with no treatment on nocturnal cough and sleep difficulty associated with childhood upper respiratory tract infections.

Design A survey was administered to parents on 2 consecutive days, first on the day of presentation when no medication had been given the prior evening and then the next day when honey, honey-flavored DM, or no treatment had been given prior to bedtime according to a partially double-blinded randomization scheme.

Setting A single, outpatient, general pediatric practice.

Participants One hundred five children aged 2 to 18 years with upper respiratory tract infections, nocturnal symptoms, and illness duration of 7 days or less.

Intervention A single dose of buckwheat honey, honey-flavored DM, or no treatment administered 30 minutes prior to bedtime.

Main Outcome Measures cough frequency, cough severity, bothersome nature of cough, and child and parent sleep quality.

Results Significant differences in symptom improvement were detected between treatment groups, with honey consistently scoring the best and no treatment scoring the worst. In paired comparisons, honey was significantly superior to no treatment for cough frequency and the combined score, but DM was not better than no treatment for any outcome. Comparison of honey with DM revealed no significant differences.

Conclusions In a comparison of honey, DM, and no treatment, parents rated honey most favorably for symptomatic relief of their child's nocturnal cough and sleep difficulty due to upper respiratory tract infection. Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection.

Then we can have a look at some coverage given to this study:

(December 3, 2007 - Insidermedicine) Giving children honey can help relieve nighttime cough symptoms associated with a cold better than over-the-counter cough medicine, according to a study published in this months issue of Archives of Pediatrics & Adolescent medicine.

Here is some facts about managing colds and coughs in children:

• Over-the-counter cold and cough medications and acetaminophen (commonly known as Tylenol®) do not shorten the duration of colds.
• cold or cough medications are not recommended for patients under the age of 2 years.
• For children over two years, cold and cough medications should be used very sparingly, if at all. If they are to be used, it is important to follow directions on the product label very carefully.

Researchers from Penn State College of medicine asked the parents of over 100 children aged 2 to 18 with colds to give their children honey, the over-the-counter cough suppressant dextromethorphan, or nothing at all 30 minutes before the children went to bed. All the children had been ill for a week or less and were suffering from nighttime cold symptoms. The parents filled out a survey about their children's cold symptoms the night before and the night after treatment.

Overall, honey was found to be more effective at suppressing the children's cough and helping them sleep than either dextromethorphan or no treatment. In addition, dextromethorphan was no better than no treatment at all in terms of controlling the children's cough.

This research highlights the benefits of honey, which is believed to be safe for children at least one year of age, for controlling nighttime coughing associated with a cold. It also provides additional evidence, on top of that which has already been collected, that dextromethorphan is not a useful cough suppressant for children.

And also:

Honey is better than children's cough syrups for a silent night
David Rose, December 4, 2007

Natural honey is a more effective remedy for children's coughs than over-the-counter medicines, researchers say. A dose of buckwheat honey before bedtime easily outperformed a cough suppressant in a US study.

Honey did a better job of reducing the severity and frequency of night-time coughs. It also improved sleep quality for children and their parents.

Dextromethorphan (DM), the active ingredient in many cough mixtures sold in chemists and supermarkets, had no significant impact on symptoms. Honey has been used in medicine for centuries, not only to treat coughs and bronchitis but also to assist the healing of wounds. For coughs it is often mixed with lemon, ginger or brandy.

Ian Paul, who led the researchers from Penn State College of medicine in Hershey, Pennsylvania, said: We hope that medical professionals will consider the positive potential of honey as a treatment, given the lack of proven efficacy, expense, and potential for adverse effects associated with the use of DM. DM can cause severe involuntary muscle contractions and spasms, the researchers said. Cases of teenagers using the drug to get high were also common, they said.

Dr Paul's team observed 105 children and teenagers with respiratory tract infections. The study ran over two nights. On the first, none of the participants was given any treatment. On the second, they were divided into groups who received either honey, an artificial honey-flavoured DM medicine or no treatment, about half an hour before bedtime.

Parents answered questions about their child's symptoms and sleep quality, as well as their own ability to sleep. They rated honey as significantly better for the relief of symptoms. The findings are reported today in the journal Archives of Pediatrics & Adolescent medicine.

-- The Food Standards Agency says that honey should not be fed to children under the age of 1 due to the risk of the bacteria Clostridium botulinum.

And also:

Honey Eases Nighttime cough
By Anne Harding

NEW YORK (Reuters Health) - A spoonful of honey can quiet children's nighttime cough and help them -- and their parents -- sleep better, a new study shows.

When compared to the cough syrup ingredient dextromethorphan or no treatment, honey came out on top.

"The results were so strong that we were able to say clearly that honey was better than no treatment and dextromethorphan was not," Dr. Ian M. Paul of Pennsylvania State University in Hershey, one of the study's authors, told Reuters health.

There is currently no proven effective treatment for cough due to an upper respiratory infection like the common cold. While dextromethorphan is widely used, there is no evidence that it works, and it carries risks.

Honey is used around the world as a folk remedy for cough, and might provide a safe, effective alternative to cough medicine, Paul and his colleagues note in the Archives of Pediatrics and Adolescent medicine.

To investigate, they compared buckwheat honey, a honey-flavored dextromethorphan preparation, and no treatment in 105 children who had sought treatment for nighttime coughs due to colds. Parents were surveyed on the day of the doctor's visit and on the next day, after those in the treatment groups had given their kids honey or dextromethorphan at bedtime.

Among the three groups, children given honey had the greatest reduction in cough frequency and severity, and the most improved sleep, as did their parents.

There are several explanations for why honey might ease cough, Paul and his team note; its sweet, syrupy quality may be soothing to the throat, while its high antioxidant content could also be a factor. Honey also has antimicrobial effects.

Honey isn't recommended for infants younger than one year old, because of the rare but serious risk it might cause a type of food poisoning known as botulism, Paul said in an interview. For older kids, however, it is generally safe. He and his colleagues used a dosage identical to that recommended for cough syrups: half a teaspoon for two- to five-year-olds, a teaspoon for six- to eleven-year-olds, and two teaspoons for children twelve and older.

"The study offers an interesting alternative to traditional over-the-counter remedies for cough in children," Dr. Michael Warren of Vanderbilt University in Nashville, Tennessee and colleagues conclude in a commentary accompanying the study.

Just to reiterate that you should avoid giving honey to children less than 12 months old. Honey can sometimes contain spores of clostridium botulinum - various studies show that between 5%-15% of honeys randomly tested can contain these spores, and these spores are actually common in soil and dust too. Bees sometimes carry these spores, and they end up in the honey. Babies less than 12 months do not have a fully matured gut, their intestine is very small and its condition is favourable to the spores that can multiply and release toxin, leading to botulism, which is a rare, but serious type of food poisoning.