Cornelius W. Van Niel, MD

Parents perceived improved cough symptoms and sleep in young children after a nighttime dose of agave nectar or placebo compared with no treatment.

Young children with cough have trouble sleeping and so do their parents. Honey has been shown to decrease cough symptoms but cannot be given to infants because of the risk for botulism (NEJM JW Pediatr Adolesc Med Aug 15 2012). In a partially double-blind, randomized study, researchers compared the effect of a single bedtime dose of pasteurized agave nectar (not associated with botulism), like-flavored placebo, or no treatment in 120 children (age range, 2–47 months) presenting with <7 days of cough in general pediatrics practices.

Comparison of parent symptom assessments using a validated nocturnal pediatric scale on the night before and the night of treatment showed improvements in all three groups in cough characteristics, rhinorrhea severity, nasal congestion, and effects of cough on child and parent sleep (range, 1–3 points on a 7-point scale). For every item except cough bothersomeness to the child, symptom improvements in the agave nectar and placebo groups were similar and significantly greater than in the no-treatment group. A nonsignificant trend favored agave nectar over placebo in the 30 children younger than 1 year.

Citation(s):

Paul IM et al. Placebo effect in the treatment of acute cough in infants and toddlers: A randomized clinical trial. JAMA Pediatr 2014 Oct 27; [e-pub ahead of print].

Taylor JA and Opel DJ.Using the placebo effect to treat cold symptoms in children. JAMA Pediatr 2014 Oct 27; [e-pub ahead of print].