Melatonin, a hormone humans produce naturally to tell our bodies that it’s time for bed, can be purchased without a prescription in supplement form. Some parents swear by melatonin supplements as a sleep aid for their children as it is shown to reduce the time it takes to fall asleep. However, few studies have been conducted on the long-term effects of melatonin supplements on children, so medical professionals are unable to vouch for its safety. “It likely is well tolerated, but the jury is still out,” says Sujay Kansagra, MD, director of the Pediatric Neurology Sleep Medicine Program at Duke University Medical Center. Here we explore what melatonin is, why it is used as a sleep aid, and how safe it is for your child to take.
What Is Melatonin?
Melatonin is a naturally occurring hormone produced by the pineal gland in the brain to help set our sleep patterns. Melatonin levels spike in the evening, prompting our bodies to start winding down for sleep. Exposure to light from our TV, laptop, and phone screens suppresses melatonin production, which means children are less likely to feel ready for sleep if they use an electronic device right up until bedtime. Synthetically produced melatonin is available to purchase without prescription in the United States, often in capsule, gummy, or liquid form. Melatonin taken this way has been shown to help reduce the effects of jet lag by syncing the traveler’s circadian rhythm, which is a series of internal body clocks that helps establish a regular sleep and wake time, in line with the new time zone. As well as jet lag, melatonin supplements are commonly used in adulthood to tackle sleep disorders or for shift workers adjusting to a new sleep-wake cycle. However, melatonin has been shown to be an effective way to combat sleep issues in childhood, too. In one study made up of six randomized controlled trials, melatonin supplements reduced sleep latency (the time it takes to fall asleep) by 11 to 51 minutes.
Is Melatonin Safe For My Child To Take?
New research shows that more Americans than ever are taking melatonin as a sleep aid, with parents turning to the supplement to help combat a range of sleep issues in children, including difficulty going to sleep and staying asleep. However, although studies indicate that melatonin is safe for children as a short-term measure, few scientific studies have explored the long-term effects of taking it in childhood. What’s more, it is not regulated by the U.S. Food and Drink Administration (FDA). As a result, experts are unable to determine how safe melatonin supplements are for your child to take on an ongoing basis. “We don’t have enough studies to say whether melatonin is safe long term,” says Dr. Kansagra. Without FDA regulation, manufacturers of melatonin supplements can put products on the shelves that are vastly different from one another, don’t have melatonin at all, or include other ingredients not stipulated on the label, explains Dr. Kansagra. One study that looked at 31 commercially available types of melatonin found that the actual melatonin content varied from -83% to +478% of the labeled amount. “Parents ask me at least five or six times a week in my clinic if they can give their child melatonin,” says Cora Collette Breuner, MD, MPH, FAAP, professor of Pediatrics and Adolescent Medicine at Seattle Children’s Hospital and the University of Washington. “It’s considered a supplement, so it’s not regulated by the FDA, so it’s exempt from any surveillance unless there’s an adverse effect. So it looks good because it’s packaged in a bottle on a shelf in a pharmacy, but that doesn’t necessarily infer that it’s safe or it’s regulated.” There is also some suggestion that long-term melatonin use may cause some disruption to the onset of puberty, either delaying it or causing it to start too soon. However, there is currently no robust data to support this. To err on the side of caution, Dr. Breuner does not recommend melatonin to patients under the age of 13: “I don’t think there’s enough data or robust evidence to show efficacy and there’s not enough safety data.” However, while it is generally not advised to use melatonin as a quick fix to solve behavioral sleep problems, studies show that melatonin can be an effective sleep aid for children with neurodevelopmental disorders, such as ADHD, who struggle to both fall and stay asleep. In these instances, slow or prolonged-release melatonin taken under the direction of a pediatrician could help children fall asleep and prevent frequent waking.
Benefits of Giving Your Child Melatonin
For some parents, any potential risk associated with their child taking melatonin on a long-term basis is offset by the benefits of getting good quality sleep. An improvement in memory, mood, and ability to focus are just some of the advantages of a restorative night’s sleep. “I can’t say enough about how important sleep is,” says Dr. Breuner. However, melatonin supplements should not be your first course of action when tackling your child’s trouble sleeping. “Most young children who can’t sleep actually have behavioral causes to insomnia, such as limit-setting challenges or an association with caregiver presence that is needed to help with the transition to sleep,” says Dr. Kansagra. “Although it may be tempting to try treating these with melatonin, the best solution is to implement behavioral modification strategies that help with limit-setting and teach children to become self-soothers.” Before reaching for melatonin, Dr. Kansagra recommends improving your child’s sleep hygiene. You can do this by implementing a nighttime routine that lasts around 20 minutes and avoiding screens and bright light for a minimum of 30 minutes before bed, as this is shown to suppress our body’s own natural melatonin secretion. Although the ongoing use of melatonin supplements might not be recommended for all children, there is evidence to suggest that taking them could improve the ability of children with neurodevelopmental disorders, such as ADHD, to fall and stay asleep. “There is some data [recommending] that kids who have received an autism disorder diagnosis who do have significant trouble falling and staying asleep—and this has to be done with the support of a prescriber—[take melatonin],” says Dr. Breuner. Again, this should be given to your child under the direction of their pediatrician.
Safety Precautions
Studies suggest that melatonin is generally considered safe for children to take on a short-term basis, but further research needs to be conducted before it is considered a safe long-term sleep aid. It’s also worth noting that although melatonin is available as an over-the-counter supplement here in the United States, elsewhere in the world it is considered a drug and is only available via prescription. It is not recommended that you give your child melatonin unless advised to by their pediatrician or healthcare provider. If you have been advised that melatonin may be beneficial for your child, there are some safety precautions you can take into consideration to help minimize any risk.
Possible Side Effects
Short-term melatonin use may cause your child some unpleasant side effects, such as headaches, bedwetting, nightmares, daytime tiredness, and dizziness. Other potential side effects include heart palpitations, agitation, and mood swings. The good news is that these side effects cease with the discontinuation of melatonin use.
Keep Dosage Low
There is currently no official dosage guidance for melatonin supplements, leaving parents to use their discretion. “The best data we have for melatonin is to use very small doses very early at night to help shift the circadian rhythm,” says Dr. Kansagra. While melatonin is safe in the right dose, melatonin poisonings have increased over the last decade. Without official guidance, you should discuss the recommended dosage for your child with their healthcare provider.
Make Sure the Bottle Has USP Verification
Without FDA regulation, consumers are unable to rely on the ingredients list displayed on the side of melatonin supplements as an accurate account of its contents. One study found that even the same melatonin products were vastly different from one another, didn’t contain melatonin at all, or included other ingredients—including serotonin—not stipulated on the label. To ensure your melatonin contains what it says it does (and without any hidden ingredients), look for a bottle with a USP verification. This means that the product has been tested by the United States Pharmacopeial Convention.
Melatonin and Vegetarians and Vegans
Melatonin supplements are often made using a synthetic form of melatonin. However, it is sometimes made from an ingredient called ‘bovine pineal gland,’ which means the melatonin has been sourced from the pineal gland of a cow. For vegetarians, vegans, and those who are unable to consume cow for religious reasons, check the label carefully.
A Word From Verywell
The long-term side effects of taking melatonin remain unclear, so experts agree that taking melatonin supplements should not be your first course of action when trying to improve your child’s quality of sleep. Instead, implement a calm and consistent bedtime routine that includes a ’tech bedtime’ of at least 30 minutes before sleep. Shutting off the blue lights of their screens will help encourage your child’s own natural melatonin secretion. If sleep is something your child continues to struggle with after improving their sleep hygiene, consult with their pediatrician for more advice.
