Updated

Agave nectar can be a low-risk, successful way to treat a child’s nighttime cough, suggests a study published in the journal Jama Pediatrics.

While honey is not recommended for children under age 1 because it can cause botulism, agave nectar has proved to be a viable treatment for treating a cough in children without the risk. Botulism is a serious condition that occurs when bacterial spores grow in a baby’s intestinal tract.

In the study, Penn State University researchers compared the effects of agave nectar to a placebo— in this case, grape-flavored water— in children ranging from two months to four years old.

“The agave nectar and the placebo water actually both had a significant impact on the criteria that they looked at and those criteria were things like less coughing at night and less bothersome coughing,” said study author Dr. Deb Lonzer, of Cleveland Clinic Children’s Hospital.

When researchers took a closer look, they found that the agave nectar outperformed the grape water in treating children’s coughs.

The study authors say their findings may suggest a “placebo effect” for antibiotic prescriptions—the idea that medicine is effective based only on one’s personal belief but not scientific evidence.

“Some of what we have to do is to teach parents that not everything needs to be treated because that can bleed over into those diseases that we’re treating with antibiotics that really don’t need antibiotics,” Lonzer said. “It’s another part of the education that you may just not have to treat everything.”