Does Honey Help with Colds?
Yes, honey is effective for reducing cough and sore throat symptoms in viral upper respiratory tract infections for patients older than 12 months, and it is the only treatment with proven efficacy for acute cough in children. 1
Evidence for Honey's Effectiveness
Honey provides superior symptom relief compared to multiple alternatives:
Honey reduces cough frequency better than no treatment (mean difference -1.05 on a 7-point scale) and placebo (mean difference -1.62), with moderate-certainty evidence from systematic reviews. 2
Honey performs similarly to dextromethorphan for cough frequency reduction, but dextromethorphan should be avoided due to lack of proven efficacy and potential adverse effects in children. 1, 2
Honey is superior to diphenhydramine for reducing cough frequency (mean difference -0.57), and antihistamines have minimal to no efficacy for cough relief. 1, 2
A 2021 systematic review and meta-analysis demonstrated that honey improved combined symptom scores (mean difference -3.96), cough frequency (standardized mean difference -0.36), and cough severity (standardized mean difference -0.44) compared with usual care. 3
A 2022 randomized controlled trial showed that nighttime honey doses significantly reduced cough frequency and severity scores (both dropping from median 5.00 to 0.00) and improved sleep for both children and caregivers, outperforming diphenhydramine. 4
Mechanism and Practical Use
Honey works as a demulcent with antimicrobial properties, and guidelines specifically recommend it for acute cough in children. 3, 5
Dosing: A single dose of honey before bedtime has been shown to diminish cough and discomfort, though recent evidence also supports administering a few daily doses. 5
Patient perception: In primary care surveys, 77-94% of patients using honey for upper respiratory symptoms considered it effective. 6
Critical Safety Warning
Never give honey to infants under 12 months of age due to the risk of infant botulism. 1
Why Honey Over Other Treatments
The European Society for Clinical Microbiology and Infectious Diseases recommends ibuprofen or paracetamol for relief of acute sore throat symptoms, but does not recommend zinc gluconate, and notes inconsistent evidence for herbal treatments. 7 However, for cough specifically, honey has the strongest evidence base.
Over-the-counter cough and cold medicines should not be used in children as they have not been shown to make cough less severe or resolve sooner, and are associated with significant morbidity and mortality. 1, 8, 9
Adverse Events
Honey has a favorable safety profile. In studies comparing honey to other treatments, gastrointestinal symptoms occurred in 12% of children receiving honey versus 11% receiving placebo (not statistically significant). 2 This compares favorably to dextromethorphan (nervousness, insomnia, hyperactivity in 9.3% of children) and diphenhydramine (somnolence in 7.5%). 2
When to Seek Further Evaluation
Most acute coughs from viral URTIs are self-limiting, but re-evaluate if cough persists beyond 2-4 weeks for emergence of specific etiological pointers requiring systematic evaluation. 1