Single dose of honey effective for cough in kids

I take care of a lot of kids. With the recent withdrawal of so many children's cough/cold meds, I was happy to see this "old fashioned" remedy determined useful. And it's cheap.

From InfoPOEMS...

Clinical Question:
Is honey effective for cough suppression in children?

Bottom Line:
A single dose of honey is effective at decreasing cough severity and sleep disruption in children with cough due to uncomplicated upper respiratory infections. Please remember that honey should never be given to infants because of the risk of botulism. (LOE = 2b)

Reference:
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;161(12):1140-1146.

Study Design:
Randomized controlled trial (double-blinded)
Funding:
Industry
Setting:
Outpatient (any)
Allocation:
Uncertain

Synopsis:
Children aged 2 years to 18 years with cough attributed to upper respiratory infections of less than 7 days' duration were randomly assigned to receive honey (n = 35), specially compounded honey-flavored/honey-scented dextromethorphan (n = 33), or no treatment (n = 37). The honey and dextromethorphan were administered 30 minutes before bedtime. The honey was dosed by age: children aged 2 years to 5 years received 8.5 mg (1/2 teaspoon), 6- to 11-year-olds received 17 mg (1 teaspoon), and 12- to 18-year-olds received 34 mg (2 teaspoons). Only children whose coughs were moderately disruptive were eligible to participate. The researchers used multiple exclusions to limit this to viral respiratory infections. The authors main justification for using a no treatment arm instead of a placebo group was that in a previous study they found dextromethorphan to be equivalent to placebo. Although the no treatment group obviously knew what they were getting, the other 2 groups were unaware of their treatment. The parents of the children provided ratings of cough severity, effect on sleep, and so forth at baseline and the next day. Only 81% of the children enrolled completed the study. Every treatment group improved by the second night, even those receiving no treatment. Children in the 2 treatment groups had slightly greater reductions in cough frequency than untreated children. Children receiving honey had slightly greater improvements in cough severity and in sleep disruption. Five parents reported hyperactivity, nervousness, and insomnia in children treated with honey compared with 2 parents of those treated with dextromethorphan, and 0 of those receiving no treatment.