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CPD ACTIVITY 75 of age due to the risk of botulism.13 Additionally, the World Health Organisation recommends honey to treat sore throats in young children (not under one year of age), due to its demulcent properties.15 Considering the safety profile of honey and recent evidence, as well as its long history of use, honey-based preparations are a useful remedy for coughs and sore throats in children over one year of age. The Royal Children’s Hospital Melbourne recommends one to two teaspoons of honey taken half an hour before bedtime for children over 12 months of age, as this may help reduce the severity and duration of the cough.1 Ginger Zingiber officinale As with honey, ginger is widely used as a food and also for medicinal purposes. Combined with honey, it has a traditional history of use as a sore throat remedy and may be useful for reducing symptoms of coughs associated with common colds. However, clinical trials studying ginger as a cough remedy in children are limited. The taste and smell may be too pungent for small children. Steam inhalations and humidifiers Steam inhalations are not recommended for children as there is insufficient literature to support their use, especially considering the risk of burns from this intervention. Studies have shown that steam inhalation to treat a common cold provides no additional benefits, but research in the UK indicates that 80 per cent of general practitioners continue to recommend steam inhalation as a home remedy to their patients.16 Cool mist humidifiers can be recommended as an alternative if a parent wishes to add moisture to the air. When to refer a cough in a child It’s important for pharmacists to know when children presenting with a cough may need to be referred to their medical practitioner for further investigation. Table 1 outlines instances or presenting symptoms that should be referred. However, the list is not exhaustive and there may be other factors that may also warrant a referral. If in doubt, it’s best practice to refer the patient to their doctor for a thorough assessment. Table 1. Symptoms/situations which require referral to a doctor1,17 • Child less than two years of age. • Cough accompanied by high fever. • Child is experiencing difficulty breathing (wheezing or whooping noise). Skin appears blue or grey – may indicate hypoxia. • Child is not drinking water. • A persistent cough that has lasted more than three to four weeks. • Child with pre-existing health conditions. Conclusion While conclusive evidence may not be available for all the natural remedies outlined above, pharmacists are encouraged to use their clinical knowledge and professional judgement when recommending symptomatic relief for coughs in children. TO PAGE 76 Australasian College of Pharmacy Become a member of the new look Australasian College of Pharmacy With many new education opportunities Visit acp.edu.au to learn more and sign throughout 2021, now is a great time to up for updates. become part of the College community. +61 7 3144 3680 • info@acp.edu.au • acp.edu.au ABN: 44 008 588 841 • RTO Code: 88112 RETAIL PHARMACY • MAY 2021 21_00006N