Honey for Cough

A 2007 Penn State trial (Paul et al., 105 children aged 2 to 18, one night) gave buckwheat honey, honey-flavored dextromethorphan (DM, the active ingredient in most OTC cough suppressants) or no treatment before bed. Parents rated honey best, and honey beat no treatment for cough frequency, but its difference from DM was not statistically significant. A 2021 systematic review in BMJ Evidence-Based Medicine (Abuelgasim et al., 14 studies) found honey improved upper respiratory tract infection symptoms, including cough frequency and severity, compared with usual care; the two placebo-controlled studies it pooled did not show a clear difference. In a 2012 Israeli trial (Cohen et al., 300 children aged 1 to 5), parents rated a bedtime dose of eucalyptus, citrus or labiatae honey better than a date-extract placebo for night cough and sleep. Honey does not treat the virus causing the cold.

No trial has compared honey varieties against each other for cough, so there is no proven best type. Buckwheat honey was the honey in the 2007 Penn State trial, where parents rated it best but its difference from DM was not statistically significant; it has a strong, molasses-like flavor that may take getting used to. Eucalyptus honey was one of three honeys in the 2012 Cohen trial, alongside citrus and labiatae (mint-family) honeys, and all three beat placebo. Manuka honey from New Zealand contains methylglyoxal (MGO); no cough trial shows it works better than ordinary honey, and a UMF or MGO grade is not a cough dose. Wildflower honey is a cost-effective everyday option, and clover honey is mild enough for children who dislike strong flavors. The trials used ordinary jarred honeys; there is no evidence that raw or unfiltered honey works better for cough.

There is no established dose or timing of honey for cough. The trials gave children with colds a single dose at bedtime; that reflects how the studies were designed, not a dose to follow. For children, ask your pediatrician, and never give honey to a child under 12 months old.

The evidence comparing honey with over-the-counter cough medicines is limited. A 2018 Cochrane review of 6 trials in 899 children found honey may make little or no difference compared with dextromethorphan (DM) on cough frequency and may be better than diphenhydramine, both on low-certainty evidence. Cough medicines have not been proven effective in young children and carry risks of side effects including drowsiness, hyperactivity, and in rare cases, serious adverse events — ask your pediatrician about appropriate options for children aged 1 to 5. The FDA also warns against giving OTC cough medicines to children under 2 years old. The head-to-head trials were done in children, and honey had side effects of its own in them: in the two trials that compared it with dextromethorphan, the Cochrane review counted nervousness, insomnia or hyperactivity in 7 of 75 children given honey and 2 given dextromethorphan. Honey is not an expectorant for deep chest congestion. For severe or prolonged cough, medical evaluation is appropriate to rule out pneumonia, asthma, or other conditions requiring specific treatment.

The most critical safety rule for honey is absolute: never give honey to infants under 12 months of age. Honey can harbor spores of Clostridium botulinum, and an infant's immature digestive system cannot prevent these spores from producing dangerous toxin, potentially causing infant botulism. After age one, the gut is mature enough to handle any spores safely. People with diabetes should account for the sugar content of honey when managing blood glucose — one tablespoon contains approximately 17 grams of carbohydrates. Honey raises blood sugar: US clover honey measured a glycemic index of 69 in a 2006 study, close to table sugar at 65. Allergic reactions to honey are uncommon but can occur, especially in individuals with bee or pollen allergies. Start with a small amount if you have known allergies. Honey is not appropriate as the sole treatment for whooping cough (pertussis), croup, pneumonia, or any cough lasting longer than three weeks. A chronic cough can indicate asthma, GERD, postnasal drip, or more serious conditions that require proper medical diagnosis. If your cough is accompanied by blood in the sputum, high fever, shortness of breath, or unexplained weight loss, seek medical attention promptly.