The public were agog over the new study suggesting that a teaspoon of honey helps a child with nighttime cold and cough, but the experts' reaction was more nuanced and varied.
Dr. Lawrence Rosen said that if he had not already known about the study, his patients would have made sure he heard about it.
The study, published in the December issue of the Archives of Pediatric and Adolescent Medicine, received tremendous attention from the public and the press when it was released.
A bedtime dose of buckwheat honey was more effective than was dextromethorphan or no treatment at all for quieting cough and facilitating sleep in children aged 2-17 who had upper respiratory infection (Arch. Pediatr. Adolesc. Med. 2007;161:1140-6).
The study came out shortly after a Food and Drug Administration advisory panel voted that over-the-counter cough and cold medications should not be recommended for children under age 5 years, and many major manufacturers voluntarily pulled from the stores their cough and cold products aimed at infants and toddlers.
“What perfect timing,” said Dr. Rosen, a pediatrician who practices in Old Tappan, N.J., and who is a member of the provisional section on complementary, holistic, and integrative medicine of the American Academy of Pediatrics.
Dr. Rosen said he thought the study was well designed and compelling, and that he already recommended honey, with tea, before the study, but the study gives him more reason to do so, particularly since honey is benign for children over 1 year of age.
Parents “are just happy to know there are things that they can do,” he said. “They just want to be able to do something.”
Some other experts, however, do not have such a high regard for the findings.
“I think it is reasonable to recommend honey for treatment in cough for children over 2 years old based on these results,” said Dr. James Taylor, a professor of pediatrics at the University of Washington, Seattle. But “In my own practice I will probably not yet widely recommend honey because the benefits are relatively small, and the appropriate dose and form of honey to use are not well standardized,” he said in an interview.
The mechanism of action involved with the honey treatment might only be its demulcent properties, said Dr. Taylor, who has an interest in complementary medicines. “If that is the case, any soothing cough drop might work equally well.”
Dr. J. Owen Hendley said he was not impressed with the study, but he probably would recommend honey to patients.
“It is not a knock your socks off kind of study,” said Dr. Hendley, a professor of pediatrics in the division of pediatric infectious diseases at the University of Virginia, Charlottesville, who has studied rhinovirus and colds since the 1960s.
The study used parental recall to measure cold improvement, rather than a more objective and definitive measure, noted Dr. Hendley. Moreover, all of the groups in the study had improvement in their cough, even those who received no treatment.
Dr. Hendley said he does not recommend much for a cold since nothing has been shown to have a definite benefit, but he would recommend honey. “I happen to like honey–the price is right. I can't think of anything bad about having a 1-year-old use honey,” he added.