I am sure you have seen the recent study from the CDC where they reported a 530% increase in melatonin overdoses in kids between 2012-2021. Additionally, there were 4000 hospitalizations, 300 ICU cases, and two deaths in children ages three months and 1 year old from melatonin. Quite the staggering and terrifying statistics!
But the temptation to help your child sleep is a big one. According to the AAP, 25-50% of young people have trouble falling and staying asleep. Lack of sleep is associated with plenty of negative consequences including obesity and lack of concentration. So, you can see why parents may want to aid their child’s sleep with a sleep supplement like melatonin.
When it comes to our child’s body, we need to be sure we are evaluating whatever we are giving them for its efficacy and possible side effects. There has been such a push for organic, hormone free, non-GMO, etc. foods for our kids (and us adults, too) and of course the hesitancy of medications because of ingredients (always talk to your doctor about what medication is right for your child).
But I also know, I am a busy parent. I don’t have time to look at EVERY ingredient on EVERYTHING I give my kids. Raise your hand if you do such diligent research? I mean, some people do – some don’t. Most of the time, when we are faced with a problem, we will begin grasping for whatever straw we can grab (it’s why the supplement market has skyrocketed). Even for our kids.
There are plenty of examples of this – kid’s got a cough? Put a wedge under his bed (NOT recommended by the AAP); Kid’s teething? Use a dental gel (NOT recommended by the FDA); Kid’s banging their head on the crib bars? Use bumper pads (Recently banned in the US). It is easy to see how melatonin got a “kid’s not sleeping? Give them melatonin!” quick fix for parents.
Let’s look at what Melatonin is what the controversy is all about.
What is Melatonin?
Melatonin is a hormone that’s secreted from the pineal gland that helps to settle your body and mind down when it’s time to sleep. How exactly it does that is a very complicated process and involves more biology that I can possibly hope to understand, much less explain.
Basically we begin to produce more melatonin in the evening hours when it starts getting dark to help us fall asleep. It usually shuts off in the early morning when it’s counterpart, cortisol, starts becoming more dominant. Cortisol is our natural stimulant and tells our body to wake up and stay up. These two together make our circadian rhythm or body clock.
(Newborns are something of an exception, as they don’t start producing melatonin and cortisol until they’re about 2 months old. Until then, they’re kind of flying by the seat of their pants, sleep-wise.)
An important point here is that melatonin is not a traditional sleep aid. As Dr. Luis Buenaver, a sleep expert from Johns Hopkins explains it, “Your body produces melatonin naturally. It doesn’t make you sleep, but as melatonin levels rise in the evening it puts you into a state of quiet wakefulness that helps promote sleep.”
That worked like a charm for a couple of hundred thousand years, until we invented the light bulb. And the television. And the smart phone. And the laptop.
Nowadays our eyes are flooded with so much artificial light that it can be difficult for our brains to determine when night is actually coming on, and it can interfere with melatonin production. That can mess up our body clocks and contribute to insomnia.
When I work with families, one of the things I talk a lot about is the sleep/wake environment. The bedroom should be DARK and the wake environment should be light, outside if possible! For older kids, I recommend no screen time at least 30 minutes prior to bed so their bodies have a chance to rid itself of the blue light emitted by TV, tablets, computers, etc. This goes for adults, too, in case YOU are having trouble falling asleep at night (yup, stop scrolling before bed!).
Will giving my child melatonin help them sleep through the night?
And the answer is… No, it will not.
It might help them GET to sleep at night, but it will not help them stay asleep. And this is not true for every kid, either. While research shows melatonin can help children with autism, ADHD, and other neurodevelopment disorders fall asleep faster, few studies have shown the same results in typically developing kids. So, it really is a gamble on whether it will help or not.
A friend of mine told me she gives melatonin to her eldest but it only works to help her fall asleep faster about half of the time. The National Sleep Foundation has found that, “...when scientists conduct tests to compare melatonin as a “sleeping pill” to a placebo (sugar pill) most studies show no benefit of melatonin.”
Is melatonin safe for kids?
I am not a doctor so I can not medically say yes or no. But that being said, researchers still don’t know the long term side effects of taking any amount, even sporadically on an as needed basis.
Being a sleep consultant, I work with families to discover their child’s unique and individual sleep needs. I think if parents are giving melatonin, this monkey’s with our body’s natural hormone cycle and can disrupt sleep more than it can really help it. Too much melatonin, or giving it at the wrong time, can certainly throw off the balance of your circadian rhythm. And, it is not without side effects.
Additionally, over the counter melatonin supplements are not always pure melatonin and can contain other chemicals such as serotonin or even the incorrect dosage of melatonin. For example, one study found that some chewable tablets claiming to contain 1.5 milligrams of melatonin had as much as 9 milligrams. A 478% increase from the label claim!
Finally, the FDA has not approved the use of melatonin as it is a supplement and the FDA does not regulate supplements.
Conclusion
In my practice, when a family tells me they give their child melatonin, I have them stop immediately. For one thing, I need to see what the child’s natural circadian rhythm is and I can’t do that with supplements changing that around. And, in my opinion, I haven’t seen enough compelling evidence to suggest that melatonin is safe or effective for kids (or adults).
I work with families on behavior modification and instilling healthy sleep habits free from external crutches or props, including melatonin supplements. I do this by getting a whole picture of the child and the family and get to the root cause of the restlessness. It is important for people to know how to fall asleep and stay asleep as independently as possible – THAT is a healthy sleep skill.
If we work together for a period of time and I have tried all my tricks (and I have LOTS of them!!), I will refer that family to the pediatrician or specialist so they can do further evaluation and testing to find out what is going on.
What do you think - Will you try or continue to give melatonin supplements? Why/why not?
*Always talk to your doctor regarding any significant concerns you have about your child’s health, including sleep.