Which Cough "Medicine" is Best?

By: Dr. Mechak
HINT: It’s probably not the one you think…  In fact; the best, safest, and ONLY cough medicine that we recommend for our patients is not a medicine at all. You will find it in the baking aisle instead of the medicine aisle, and it’s made by good ol’ mother nature… and her worker bees… HONEY!
Most of the over-the-counter cough medicines (Delsym, Dayquil, Mucinex, Robitussin, etc.) that you’ll find in the drug store have the same active ingredient: Dextromethorphan (DM).  Now, there is a place and time for a medication like DM, but a few reasons we don’t love it as the first option for most of our patient:

  1. The way it works:  DM works in the brain, not in the lungs or airways. It works by turning off the ‘cough switch’ in the brain. It basically tells the brain to ignore the ‘cough messages’ coming from the lungs. The problem is that we usually cough for a reason. If the cough switch is off, the lungs have no way of clearing irritating phlegm, mucous, and the other bad actors that cause the cough in the first place.  This can prolong the length of illness and increase the risk of bacterial infections in the lungs called pneumonia.
  2. It does not work very well:  Most of the data that supports DM were done in adults.  One lesson we all learned in medical school is that kids are NOT just little adults.  Their bodies are different, not just smaller.  If you look at the studies done in children, over and over again they show that DM just really doesn’t work very well. Some studies even show that it works no better than a sugar pill (placebo).
  3. It can be toxic: To be clear, at appropriate doses, DM is safe. BUT, if too much is taken, either by mistake or on purpose, it can pack a nasty punch.  Some side effects include high heart rate, tremors, agitation, hallucinations, psychosis, and even coma.

Now let’s contrast this with honey.

  1. The way it works: Honey coats and soothes the throat, increases good mucous secretion, and calms the cough sensors in the throat and upper airways.  More simply put, honey decreases the need to cough while DM and other cough medicines suppress the body’s ability to cough.
  2. It works BETTER than any medicine:  Numerous studies have looked at honey as a cough suppressant.  Time after time these studies have shown that it is not just good, but it is THE BEST.  It routinely performed better than sugar pills (placebo), DM, codeine, and a slew of other cough medications.
  3. It’s all natural:  Honey is all natural, preservative free, and has no artificial ingredients.  There is no toxicity or risk of overdose, no matter how much you take (other than a belly ache from eating too much!).
  4. It’s cheap: Money talks! If the reasons above didn’t convince you, honey is cheap and versatile.  Feel free to use it in your tea or on biscuits even if you don’t have a cough.
  5. It has support:  Honey is recommended as the best option as a cough medicine by the American Academy of Pediatrics, The American College of Chest Physicians, and the World Health Organization!

***One VERY IMPORTANT caveat about honey***.
Honey should NEVER be given to children less than 1-year-old.  Honey can carry spores for a bacteria called Clostridium Botulinum.  Kids older than 1 and adults handle this bacterial just fine, but children under the age of 1 year cannot.
Finally, remember, there are a few reasons we should see you in the office when your child has a cough.  A few big ones include:

  1. Fever and a cough:  This combination can sometimes indicate that there is a bacterial infection in the lungs that might need antibiotics.  So, if there is a cough and fever or if your child looks sick or lethargic, please come see us so we can evaluate.
  2. Working harder to breathe or breathing faster:  Some infections make it harder for the lungs to do their job.  This will manifest with your child breathing harder or faster, looking uncomfortable when breathing, or wheezing. If any of these are the case, we should see them to make sure their body is getting enough oxygen. If you are ever very worried, call 911 or go to the nearest Emergency Room.
  3. Young babies:  Any baby under 2-3 months of age should ALWAYS be seen if they have a cough, trouble breathing, or any sick symptoms.
  4. If you are worried:  You are the experts in your child… trust your parental instincts! If you are ever worried about a cough or how they are breathing, please come see us!