Researchers found placebo treatments were more effective than "watchful waiting" for children's coughs.
The U.S. Food and Drug Administration (FDA) recommends against giving cough and old medications to children under the age of two due to safety concerns and lack of evidence of effectiveness, Penn State's Milton S. Hershey Medical Center.
"Pediatricians typically tell parents, 'Don't give your child anything,' or at most give them acetaminophen or ibuprofen," said Dr. Ian Paul, professor of pediatrics. "We know sick children are miserable and can't sleep, and parents are frustrated that they can't do anything to help."
Coughing is the most common symptom seen in pediatricians' offices. Past studies have recommended honey as a treatment alternative in small children, but those under 1 year old run the risk of contracting infantile botulism. Agave nectar has similar properties to honey, but does not carry infantile botulism.
To make their findings researchers looked at 119 children between the ages of 2 and 47 months who had a non-specific acute cough and an illness duration of seven days or less. The participants were given either grape-flavored agave nectar, grape-flavored water, or no treatment. Parents were asked to report their children's cough frequency, severity, and other factors.
Both agave nectar and placebo were found to be superior to no treatment at all, and very little difference was observed between the two.
"We found that placebo was better than doing nothing," Paul said. "For kids under age one, for which there is no other option, the findings may be particularly important."
More research is required to confirm the findings, but in the future placebos could help reduce unnecessary antibiotic prescriptions in young children.
"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," Paul said. "This is a discussion that the pediatric community and parents are going to have to have."
The findings were published Oct. 27 in the journal JAMA Pediatrics.
