What should parents know about melatonin?
Trouble falling asleep or staying asleep is a problem with which anywhere from 15 to 25 percent of children or teens struggle. Increased screen time and exposure to ‘blue light,’ along with busy school and sports schedules, can make getting appropriate rest a challenge. In their quest for easier bedtimes or more restful sleep, parents and caregivers sometimes look to melatonin, an over-the-counter dietary supplement, to help. In fact, usage of the supplement is at an all-time high, and Nielson estimates sales of melatonin nearly tripled from 2018 to 2022. Here is what parents should know before they consider giving it to children:
What is Melatonin?
Melatonin is a hormone produced by the pineal gland in the human body. It’s a naturally occurring hormone that helps humans regulate their sleep and wake cycles. Over the past decade, usage of synthetic melatonin has skyrocketed, and all forms of the supplement–including pills, gummies, chewable tablets and liquids–can be found over-the-counter in grocery stores and pharmacies. Synthetic melatonin comes in different dosages, with children’s melatonin generally being one milligram in strength. While melatonin is generally considered safe and non-habit forming, it’s important to note that it’s not regulated by the Food and Drug Administration (FDA) with the purpose of being a sleep aid.
How Do I Safely Use Melatonin?
Before giving any over-the-counter dietary supplement to your child or teen, it’s important to speak to your pediatrician or family physician. There are some benefits to melatonin when used in the short term, like adjusting to new routines and schedules while traveling, but there isn’t enough research to deem it completely safe for long term usage. It’s also important to know if any ingredients in a melatonin supplement could negatively interact with any other medication your child may be on. Children under the age of three should not be given melatonin.
If you’ve consulted with your pediatrician and have decided to move forward with trying it, you’ll want to opt for a higher quality melatonin, with “USP Verified” somewhere on the packaging. Seeing the USP (United States Pharmacopeia) Verified mark on a dietary supplement label ensures the product contains the ingredients listed on the label, in the declared potency and amounts. From there, your pediatrician can recommend appropriate dosing for your child. Generally, a low dose of .5 to 1 mg around an hour before bedtime is effective for children and where parents should aim to start. Dosing guidelines may be different–oftentimes a little higher–for children with neurodevelopmental disorders like autism or ADHD, but parents should work closely with their pediatrician in monitoring melatonin usage in these cases. Children who do benefit from melatonin do not need more than 3 to 6 mg.
What Risks Are Associated with Melatonin?
As the rates of melatonin sales and usage have dramatically increased in the past decade, so have reports of poisoning in children. In the majority of cases reported from 2012 to 2021, there were no symptoms and children recovered. However, some children required a hospital stay and two children died. It’s important for parents to keep all medicines, vitamins and dietary supplements stored safely away from children. Since children’s melatonin often comes in gummy form, children can mistake it for candy if accessed. Many melatonin supplements have additional ingredients–like serotonin or lemon balm–which means synthetic melatonin isn’t the only ingredient that could be harmful in large quantities. If you suspect your child has ingested melatonin unsupervised and is showing signs of melatonin poisoning–seizures, trouble breathing or unconsciousness–call 911. More melatonin poisoning information can be found online at www.poison.org or by calling 1-800-222-1222.
Alternatives to Using Melatonin
Melatonin should never be used as a replacement for a healthy bedtime routine, which is always preferable to dietary supplements unregulated by the FDA. Successful bedtime routines often begin with consistency, and parents and caregivers should understand that all new bedtime routines take time to implement. Ensuring your child has balanced meals, adequate amounts of physical activity and limited screen time (including blue lights from tablets or cell phones) can help reset the body’s natural sleep cycle and melatonin production. If you’ve tried for some time to establish a healthy bedtime routine, including limiting screen time, without success, it might be time for a conversation with your pediatrician about other potential health problems that could be interfering with sleep.
Overall, short-term use of melatonin is likely safe, but more research is needed to determine potential side effects of long-term usage. Parents and caregivers should only aim to use it when absolutely necessary and under their pediatrician’s guidance and supervision. For more information on melatonin usage, including its safety, visit www.healthline.org, www.sleepfoundation.org, or www.healthychildren.org.
By ABC Quality Team on January 24, 2023