Healthline - September 26th 2022
If your child is having trouble sleeping, it might be tempting to reach for “natural” melatonin supplements at the drug store.
But parents may want to think twice before giving melatonin to young children and seek a physician’s opinion first, according to a new health advisory from the American Academy of Sleep Medicine (AASM).
Melatonin, a hormone that’s produced naturally in the brain and helps regulate sleep, is the second-most popular supplement that parents give their children after multivitamins.
AASM officials say this poses potential harm given that melatonin is sold in the United States as a dietary supplement and therefore is not regulated by the Food and Drug Administration.
The past decade has seen a sharp increase in melatonin-related calls to poison control centers in the United States, increasing 530 percent from 2012 to 2021, according to the
“The availability of melatonin as gummies or chewable tablets makes it more tempting to give to children and more likely for them to overdose,” Dr. M. Adeel Rishi, vice chair of the AASM Public Safety Committee, said in a press release. “Parents should talk directly with their child’s healthcare professional before giving their children melatonin products. Often, behavioral interventions other than medication are successful in addressing insomnia in children.”
“Along with the increasing mental health concerns that have presented in children and young adults during the pandemic, so too have we seen a rise in sleep disturbances, with many families looking for sleep aids for their children,” Johns told Healthline. “Given the lack of regulation of melatonin products, it’s no surprise that there has been an increase in calls to poison centers about melatonin ingestions.”
Then there’s the matter of how supplements are viewed versus other medications.
“Because melatonin, and other over-the-counter medications, are often considered harmless common household items – especially relative to prescriptions like opioids – they are usually stored in areas accessible to young children,” said Milton Cohen, president and chief executive officer of Safe Rx, a company that makes tamper-proof pill bottles for medicine.
“But, if accidentally ingested – especially in amounts more than the specified dosage – by infants or toddlers, they can be extremely dangerous,” Cohen told Healthline.
In addition to talking to a pediatric health professional, the AASM also recommends keeping melatonin out of reach of children as well as seeking advice on proper dosage and selecting melatonin with a USP Verified Mark. This independent body tests and verifies supplements’ ingredients and overall quality.
“Since melatonin is not regulated for insomnia, commercially available formulations can vary in strength and accuracy,” said Linda Beilstein, a pediatric nurse practitioner at Akron Children’s Hospital in Ohio.
“One study showed potential side effects of long-term melatonin use could be precocious puberty on discontinuation of the melatonin,” Beilstein told Healthline. “Pharmacotherapy is more likely to benefit children with complex medical, psychiatric, and neurodevelopmental issues.”
Experts say the advisory isn’t meant to say that melatonin can never be used, but rather that parents should be less cavalier about how they manage it and dole it out.
“It is safe for children and teens four years old and older to take low dosages of melatonin before going to bed in order to help them receive uninterrupted sleep,” Dr. Shirin Peters, the founder of Bethany Medical Clinic in New York, told Healthline. “Melatonin can work naturally with your body to help you fall asleep.”
But there are other approaches, too, including diet and practicing better sleep hygiene.
“The vast majority of sleep disturbances in children can be handed by behavioral therapy alone,” Beilstein said. “Parents should also establish a bedtime routine and shut off all electronics at least one hour before bedtime and don’t have electronics in the bedroom. They can also have family time in the evening to begin to slow down the effects of the day.”
It might also help to take a holistic approach to good sleep, including modifying a child’s diet and aiding their circadian rhythm with light exposure.
“I encourage a healthy diet full of fruits and vegetables, and scheduling physical activity and some time outdoors in the early morning or late afternoon light every single day,” Peters said.