Honey Study Can Use Grain of Salt

By Your Child’s Health LANCE CHILTON For the Journal

Q: How does that Mary Poppins song go? A: “Just a spoonful of (honey) makes the medicine 1/8use] go down.” Miss Poppins is probably flying in circles in her grave at that distortion. But maybe it’s true anyway.

A study of 105 Pennsylvania children with colds indicated that honey was more effective than a cough medicine and more effective than no medicine in making children’s night-time coughs better and total symptom scores. As New Mexico parents try to figure out what to do about children’s colds, it’s pleasant for us all to find something that may do more good than harm.

I like the idea, too — maybe there is something we can suggest for the unhappy, sleep-deprived parents to do for their unhappy, sleepdeprived children (colds are always worse at night). However, I’m not very impressed by the study. Reading it thoroughly, I am mystified that it has received so much attention in the press. First, the pediatricians were able to recruit only 105 children with colds over six months in a large university pediatric clinic. We probably see that many colds in our little six-doctor practice in two weeks! How did they happen to select just that small group? Second, the “children” were ages 2 to 18, making it hard to generalize the results to any smaller age group. Third, parents were asked a series of subjective questions that served as the basis for deciding that honey was better than the cough medicine, dextromethorphan, or than giving no medicine. It’s very possible that the parents wanted to see improvement when they gave the honey or artificial-honey-flavored dextromethorphan, and so saw it. Indeed, there were no differences between the two “medicines” — at least not in this small group of children. Finally, the study was supported by the National Honey Board.

Honey is a natural product, so it must be safe at least, right? Not so, and this the authors of the Pennsylvania study were careful to point out. Much honey contains the spores of the bacterium that causes botulism. Adults get botulism by eating pickled beaver tail or poorly canned green beans in which a chemical toxin produced by the germ that itself is found in these delicacies; the number of spores in honey is not nearly enough to cause illness in adults.

However, scientists in the 1970s discovered that the spores from honey can multiply in the intestine of infants, making the toxin that causes infant botulism.

Just as adult botulism is nothing to sneeze at, infant botulism is a serious disease, causing prolonged hospitalization and occasional death yearly in around 80 babies. The disease starts slowly as mild weakness and, frequently, constipation. The weakness often gets worse and worse until it affects the muscles that control breathing. In fact, more than two-thirds of babies admitted to two large children’s hospitals, in Philadelphia and Los Angeles, spent time with tubes in their airways attached to ventilators, and average time in the hospital approached one month. Clearly, honey should be avoided in the first year of life, no matter how bad the nighttime cough might be.

Several years ago, another seemingly innocuous choice, chicken soup, was actively studied by professors of medicine for use in colds and other diseases of the breathing apparatus. In Chest, the journal of the American College of Chest Physicians, a scholarly debate about the merits of chicken soup included 1970s and 1980s studies of the long-used “drug” on the thickness of nasal mucus. Not to be outdone, the journal Pediatrics discussed the dangers of chicken soup, which can be so salty that a zealously “treated” child will suffer from too much sodium in his system.

Recent Centers for Disease Control and Prevention data made it clear that a large number of infants and children have been seen in emergency rooms for ill effects of cold medicines, and a few died. Maybe dilute chicken soup is safe as a treatment, and honey might help with children over 12 months of age, but I’m not convinced by a single poorly designed study. It remains true that “if you treat a cold, it lasts a week; if you don’t treat it, it lasts seven days.” And you don’t risk side effects.

Lance Chilton, M.D., is a pediatrician at the Young Children’s Health Center in Albuquerque, associated with the University of New Mexico. He is happy to hear from those with questions at 272-9242 or lancekathy@yahoo.com.

(c) 2007 Albuquerque Journal. Provided by ProQuest Information and Learning. All rights Reserved.