Can a Spoonful of Sweetener Cure a Child's Cold Symptoms?

A new study published on October 27, 2014, in JAMA Pediatrics shows that agave nectar and placebo are more effective in treating a child’s cough than “watchful waiting” with no treatment at all.

"Pediatricians typically tell parents, 'Don't give your child anything,' or, at most, give them acetaminophen or ibuprofen," said Ian Paul, MD, MSc, a professor of pediatrics and public health sciences at Penn State College of Medicine, in a press release. "We know sick children are miserable and can't sleep, and parents are frustrated that they can't do anything to help."

The FDA currently advises against the use of OTC cough and cold medications in children aged under 2 years due to safety concerns and a lack of evidence for their effectiveness in this age group. Previously, Dr. Paul’s team published study results that determined honey was more effective than placebo for children’s coughs, but honey is not permitted in infants aged less than 1 year due to the risks of infantile botulism.

Because agave nectar shares similar properties with honey without the risks, Dr. Paul and his coauthors set out to test the effects of the sweetener in children with non-specific acute cough. To do so, the researchers randomly assigned 119 children aged 2 to 47 months with non-specific acute cough, nighttime symptoms, and an illness duration of 7 days or less to receive a single dose of grape-flavored pasteurized agave nectar, grape-flavored water, or no treatment administered 30 minutes before bedtime.

After measuring cough frequency, cough severity, and sleep quality, among other metrics, the study authors determined that both agave nectar and placebo were superior to no treatment. Although there were no significant differences detected between the 2 methods overall, agave nectar was more effective than placebo in a subgroup of 30 children under age 1, among whom there is no existing treatment option for cough, Dr. Paul noted.

“Perhaps, this is a case where giving a placebo, such as agave nectar or sugar water, can help parents and their babies get through this annoying illness," Dr. Paul said. "This is a discussion that the pediatric community and parents are going to have to have."