Coughing is one of winter’s inevitable symptoms for all families. As viruses are passed back and forth, the usual runny nose and cough can be very disruptive, especially if it’s keeping both you and your child awake all night. For cough relief, we all have our favorite cough syrups, but which ones actually work?
Unfortunately, there is no over-the-counter cough syrup that is heartily-endorsed by pediatric and family medicine academy recommendations! There is actually a growing consensus that not only do most syrups not help, but the side effects outweigh the benefits. For example, many syrups contain fever medicine, such as Tylenol (acetaminophen). If parents will combine a syrup with fever-reducing pills like Tylenol, the child could overdose. Thousands of children each year are in emergency rooms, sometimes with life-threatening symptoms, from a cough syrup overdose. In 2008, the US FDA ordered all companies to stop offering any OTC syrups to any child under 2 years old, and emphasized strict limitations for kids ages 2-6.
All the popular major ingredients – dextromethorphan, guaifenesin, and others – really have shown little to no benefit in studies. A few syrups in China may contain clenbuterol or ephedrine, which theoretically may help clear the airway, but actually doesn’t help and has major side effects at low doses. In the US, my favorite for kids was Delsym, as it contained a higher concentration of dextromethorphan and seemed to work well for some. Other people liked Benadryl syrup, but as with Delsym, it isn’t available in China.
The bright side to all this is that the most useful cough syrup may be in your home right now: Honey! Quite a few good studies have shown that a bit of honey for a child over 1 year old (not before, due to risk of botulism) has some benefit for most people, with minimal side effects. Due mostly to its thick coating, honey has some anti-inflammatory properties. Some feel that manuka honey is more effective; but manuka is extremely expensive, and I don’t think the evidence justifies the cost. For children under 5 years old, try half a teaspoon; one teaspoon for ages 6-11; and two teaspoons for kids over 12. Adding some lemon also helps with throat swelling and loosening up of mucus. Remember to brush teeth afterward.
My favorite Chinese medicine is a honey-based cough syrup called pipagao (枇杷膏). I’ve found this very tasty, thick syrup with minimal side effects to be more effective than Tylenol Cold and Robitussin. Pipagao’s main ingredient is honey, along with many Chinese herbs including loquat fruit (pipa).
Of course, a cough can mean many things: Is it pneumonia, asthma, or a bacterial infection? If your child’s cough seems much worse than the usual viral illness, check in with your doctor.
Photo by GenBug via Flickr