Cough, Cough, Au chew! Why We Do Not Recommend Cough Medicine for Infants and Young Children
Side Effects and Missteps
Have you ever read the side effects on cough medicine? Yeah, neither had I until I got pregnant. Now, I find myself reading the side effects on everything. Cough medicine has some serious side effects, like slowed breathing, which is life threatening in infants and young children. Therefore, it is best to keep cough medicine for children 12+.
Fear not! There are still some treatment options to help your little one fight off that nasty cold, and it’s not antibiotics. Antibiotics are used to treat bacteria not viruses, which are the most common cause of a cold in children.
Honey, Honey, Hoooney, HON-NEY! (OVER 1 ONLY)
Honey for children OVER 1 has been used to effectively treat coughs and cold symptoms. In a study of 300 children ages 1 – 5 years old, researchers sought to find out if honey could be used to treat bothersome nighttime coughs. Some children received no honey and other children were given honey 30 minutes before bedtime. Researchers found that the families that gave their children honey showed significantly greater reductions in cough frequency, severity, how bothersome the cough was, and both child and parental sleep disturbances. Meaning children that took honey, coughed less often, not as hard, and slept better.
In a similar study, researchers found honey performed as well as or better than dextromethorphan (cough medicine), when treating coughs and colds.
Clinical takeaway: A single dose (~10 g) of honey before bed can be a safe, preferential remedy for children over 1 year old suffering from nighttime cough and sleep issues due to colds.
Why no honey under 1? Babies under age 1 should not be given honey because a type of bacteria called Clostridium that causes infant botulism can cause muscle weakness (poor suck, weak cry, constipation and floppiness). As children age, they can have honey because the digestive system moves the bacterial spores through the body before they cause harm.
Under 1 Something Can Still Be Done
Now, I know what you’re thinking, what about my poor 6-month-old with his/her first cold? I’ve been there, and the good news is there are options for you too! You could try:
Cool-mist humidifiers
Saline nasal drops or sprays
Nasal suction for infants
Acetaminophen (Tylenol) for babies over 2 months or ibuprofen for fever/aches for babies over 6 months
Ensuring they are well-hydrated
TLDR
Don’t give you 1 - 12-year-old cough medicine, instead give them honey – it’s sweeter and safer. And many of the over the counter meds are basically honey anyway! For your under 1 year old, try: humidifiers, saline drops/sprays, nasal suction, Tylenol (if over 2 months) or ibuprofen (if over 6 months) , and keeping your baby well hydrated. Always ask questions and talk to your pediatrician or MPF if you have any concerns!
References
Cohen HA, Rozen J, Kristal H, Laks Y, Berkovitch M, Uziel Y, Kozer E, Pomeranz A, Efrat H. Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study. Pediatrics. 2012 Sep;130(3):465-71. doi: 10.1542/peds.2011-3075. Epub 2012 Aug 6. PMID: 22869830.
Garbutt JM, Sterkel R, Banister C, Walbert C, Strunk RC. Physician and parent response to the FDA advisory about use of over-the-counter cough and cold medications. Acad Pediatr. 2010 Jan-Feb;10(1):64-9. doi: 10.1016/j.acap.2009.07.002. Epub 2009 Oct 12. PMID: 19819775; PMCID: PMC3433755.
Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med. 2007 Dec;161(12):1140-6. doi: 10.1001/archpedi.161.12.1140. PMID: 18056558.
U.S. Food and Drug Administration. (2024, November 7). Should you give kids medicine for coughs and colds? FDA. https://www.fda.gov/consumers/consumer-updates/should-you-give-kids-medicine-coughs-and-colds
Bjornson CL, Klassen TP, Williamson J, Brant R, Mitton C, Plint A, Bulloch B, Evered L, Johnson DW; Pediatric Emergency Research Canada Network. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004 Sep 23;351(13):1306-13. doi: 10.1056/NEJMoa033534. PMID: 15385657.
Why Should Babies Not Have Honey? | Nemours KidsHealth