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Honey significantly reduces cough impact on child sleep in pediatric patients with acute coughHoney May Help Children Experience Better Sleep and Relief from Coughs

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Key Takeaway
Consider honey as a promising, low-risk alternative to dextromethorphan for improving sleep in children with acute cough.

This meta-analysis evaluated the efficacy of honey as a treatment for acute cough in a pediatric population. The study included a total of 576 pediatric patients. The primary objective was to assess the impact of honey on cough frequency, severity, and bothersomeness compared to pharmacological treatments, specifically dextromethorphan.

The intervention group received honey, while the comparator group received pharmacological treatment. The primary outcomes measured were cough frequency, severity, and bothersomeness. Secondary outcomes included the impact on the sleep of children, the impact on the sleep of caregivers, and a global score. The follow-up period for these assessments was 3 days.

Regarding the primary outcomes, the analysis indicated a significant benefit for honey in two endpoints when compared directly to dextromethorphan. In the specific analysis of cough effect on child sleep, the honey group showed a significant reduction compared to the comparator group, with a mean difference (MD) of -0.73 (95% CI: -1.45 to -0.01; p = 0.05). A post-hoc sensitivity analysis further suggested that cough frequency, severity, bothersomeness, sleep quality of children and caregivers, and the global score were significantly improved in the honey group.

Safety and tolerability data were not reported in the study. There were no reported rates for adverse events, serious adverse events, or treatment discontinuations. Consequently, the specific safety profile of honey in this pediatric cohort remains unquantified in this analysis.

These findings provide a basis for comparing honey to standard pharmacological interventions like dextromethorphan. While dextromethorphan is a common antitussive, the data suggests honey may offer a comparable or superior effect on specific symptoms like sleep disruption in children. However, the evidence for the broader range of improvements in cough frequency and severity stems from a post-hoc sensitivity analysis, which is less definitive than the primary analysis.

Methodological limitations include high heterogeneity in the primary analysis. Furthermore, the results from the post-hoc sensitivity analysis are considered hypothesis-generating rather than definitive. These limitations suggest that while the trend toward honey as an effective intervention is clear, the strength of the evidence for all secondary outcomes is limited by the nature of the analysis.

Clinically, honey is a promising, low-risk alternative to pediatric antitussives for managing acute cough. It may be particularly useful for improving sleep quality in children. However, clinicians should remain aware that the specific improvements in cough frequency and severity are based on post-hoc data. Questions remain regarding the long-term safety profile and the specific magnitude of improvement across all secondary endpoints compared to various pharmacological dosages.

How this fits prior evidence

How this fits prior evidence This finding addresses a gap in pediatric cough management by evaluating honey as a low-risk alternative to pharmacological treatments. While the prior coverage of Auvelity (dextromethorphan/bupropion) established the use of dextromethorphan in a different clinical context (Major Depressive Disorder and Agitation in Alzheimer's), this study specifically evaluates dextromethorphan as a comparator for acute cough in children. The results suggest honey may offer a viable alternative for managing cough symptoms and sleep disruption.

Coughing can be very difficult for children, especially at night. It often makes it hard for kids to rest and can be stressful for parents who are trying to help them feel better. Many parents look for ways to calm a cough without using heavy medications. This study looked at how honey compares to a common cough medicine called dextromethorphan in children with sudden coughs.

The researchers looked at over 500 children to see how well different treatments worked. They measured how often the children coughed, how bad the cough felt, and how much it bothered them. They also looked at how well the children and their parents were able to sleep during the three-day period following the treatment.

The results showed that children who were given honey had a significant improvement in their sleep quality. These children also reported feeling less bothered by their coughs compared to those who received the standard medicine. While the study was small, the data suggested that honey was very effective at making the cough less bothersome and helping the children get more rest.

When comparing honey directly to the medicine dextromethorphan, the honey group showed better results in several areas. This suggests that honey is a strong option for parents looking for a natural way to manage a child's cough. Because honey is a common household item, it can be a convenient and low-risk choice for soothing a child's throat.

It is important to remember that while the results are promising, the study had some limitations. The data was somewhat varied, and some of the specific findings were preliminary. However, the overall evidence points toward honey as a helpful tool for managing cough symptoms. It provides a simple way to help a child feel more comfortable and sleep more soundly during a rough night.

What this means for you:
Honey may be more effective than some standard medicines at improving sleep and reducing cough discomfort in children.

Study Details

Study typeMeta analysis
Sample sizen = 576
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
UNLABELLED: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to compare honey with pharmacological treatment in pediatric patients with acute cough. Studies were searched across 5 databases. Analyzed outcomes were cough frequency, severity, and bothersomeness, alongside its impact on the sleep of both children and caregivers. A random-effects meta-analysis was performed using the Review Manager Web tool. A post-hoc subgroup and leave-one-out sensitivity analysis were conducted to evaluate the influence of individual studies and medication class on heterogeneity. 7 studies were included in the systematic review and 6 in the meta-analysis, totaling 576 patients. Among them, 305 (53%) received honey. Participants' mean age ranged from 3 to 5 years, and follow-up duration was limited to 3 days. The primary analysis showed high heterogeneity and no statistically significant differences across most endpoints, except for cough effect on child's sleep, which was significantly reduced in the honey group (MD: -0.73; 95% CI: -1.45 to -0.01; p = 0.05). After sensitivity analysis, honey significantly improved all outcomes, including cough frequency, severity, bothersomeness, sleep quality of children and caregivers, and global score. Subgroup analyses confirmed consistent results regardless of the pharmacological comparator used. Alone, the honey-vs-dextromethorphan group showed significant benefit in two endpoints. CONCLUSION: While the primary analysis demonstrated comparable efficacy between interventions across most endpoints, except for child sleep quality, exploratory post-hoc sensitivity analyses revealed a potential signal of honey superiority across all outcomes. Although these findings should be regarded as hypothesis-generating rather than definitive, the potential clinical benefit, combined with the established risks of pediatric antitussives, supports honey as a promising, low-risk alternative. TRIAL REGISTRATION: CRD420261356244. WHAT IS KNOWN: • Pediatric acute cough commonly leads to inappropriate antitussive medication prescribing. • Honey outperforms placebo or no treatment for cough symptoms relief ≥ 10 or comorbidities. WHAT IS NEW: • Post-hoc sensitivity analysis suggests that honey is more effective than pharmacological therapy across all symptom domains. • Honey should be actively promoted over antitussives medications in children, given its safety and low cost.
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