I think Marty makes a good point, that lack of proof of efficacy does not equal proof of lack of efficacy, and we have to be careful not to throw the baby out with the bathwater (particularly important since we'd probably be on the hook to treat the baby's injuries). The AAP position is that "Over-the-counter cough and cold medicines do not work for children younger than 6 years and in some cases may pose a health risk." Age 6, not all kids.
The 2012 Cochrane review on OTC medications for acute cough concluded:
"There is no good evidence for or against the effectiveness of OTC medicines in acute cough. The results of this review have to be interpreted with caution due to differences in study characteristics and quality. Studies often showed conflicting results with uncertainty regarding clinical relevance. Higher quality evidence is needed to determine the effectiveness of self care treatments for acute cough."
I can't access the full text of that right now, so the details may contradict their stated conclusion, but the gist seems to be that the evidence isn't clear, not that it's clearly negative.
Based on the AAP guidance, I recommend honey alone for children between 1 and 6. But, if a family really wants to try something for a bothersome cough in a child over 6, I suggest they try dextromethorphan, and I prescribe it if that would help them. And when I have a really bad cough, I take it.
Marissa Hendrickson, MD
University of Minnesota Amplatz Children's Hospital
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