Melatonin for kids?

Has there ever been a parent who didn’t want their child to sleep longer or fall asleep more easily? Probably not. So, when people claim a supplement like melatonin can help children do just that – and it’s a compound that occurs naturally in the body, anyway – it feels like a giant win for tired parents everywhere.

But before you start doling out melatonin gummies each night before bed, Erick Viorritto, MD, board-certified pediatric neurologist with Nemours Children’s Health, Jacksonville, and director of the Pediatric Sleep Center at Wolfson Children’s Stys Neuroscience Institute, shared important information parents should know.

Does melatonin really work?

Dr. Viorritto said melatonin can be effective, but only when it’s used to treat specific disorders. For children without these conditions, it may not do much.

“Melatonin is a hormone our brain produces to regulate sleep, and children who have a disorder of the circadian rhythm are typically treated with it,” he said. “There are also many children with neurodevelopmental differences, like autism spectrum disorder, who struggle with sleep. There’s good research showing melatonin is helpful for those children. Its biggest impact is aiding in falling asleep at the beginning of the night.”

Is melatonin safe for kids?

While Dr. Viorritto said melatonin is safe when used appropriately, parents should do due diligence on a product before giving it to their children.

“The biggest thing every parent needs to understand is this: Melatonin is classified as a supplement, so it's not regulated by the FDA at all like over-the-counter or prescription medications are,” he said. “Dosing is an issue. Studies have measured melatonin products and 70% didn't contain anywhere near the dose listed on the bottle. They were far off, ranging from 80% less than advertised to 500% more. The most variability was in the chewable supplements, which is what you would tend to give a child.”

Dr. Viorritto added that, even more concerning, one-fourth of the products tested in the study contained other supplements or medications that weren’t advertised as being present, like serotonin, a regulated substance that can affect mood.

It could also cause some unwanted side effects.

“It’s generally sold in doses from one to 10 milligrams, but we actually use much lower doses than that when treating circadian disorders. At higher doses, you can have side effects like increased nightmares, which would lead to more wakings,” Dr. Viorritto said.

Where can parents find the safest melatonin for children?

If your child’s doctor recommends melatonin, look for a product that bears the U.S. Pharmacopeia (USP)-verified label. The USP is an independent, nonprofit organization that measures the safety and quality of medicines.

“To get that mark, the manufacturer has to follow certain standards in their facility and verify that their product meets certain quality controls, including having the advertised amount of melatonin on the label and no additional compounds. It can be hard to find, but at least with that on the bottle you know there have been checks and you’re giving your child exactly what you think,” Dr. Viorritto said.

Can children overdose or become reliant on melatonin?

In the last 10 years, the number of calls to poison control hotlines for melatonin ingestion in children has increased by more than 500%. In the vast majority of those cases, the child had no significant symptoms, but in 15%, the child had to be hospitalized. Reasons included headaches, dizziness, vomiting, and extremely high or low blood pressure.

“In most of those cases, we were typically seeing very young children who got access to a bottle of melatonin, thought it looked like candy, and took very large quantities of it,” Dr. Viorritto said. “You would never leave a prescription or over-the-counter medication accessible to children, but anything that can affect our brains and other organs is considered medication, and should be treated that way in the home.”

If my child has trouble sleeping, what are my other options?

Dr. Viorritto acknowledged that many parents don’t want to do a sleep study or put their child on sleeping medications, and may view melatonin as a more natural place to start. However, your child could actually get better sleep without having to take anything at all.

“The first thing to do is talk to your pediatrician. Difficulty falling asleep is a common pediatric sleep disorder, and insomnia can be treated,” he said. “There are things to help childhood insomnia that have been studied and are very effective, and most of them are behavioral interventions.”

For example, parents might try keeping their kids away from screens for two hours leading up to bedtime. Blue light from technology shuts down the brain’s own melatonin production, so rather than giving a child a supplement, you can support their body’s natural process of getting sleepy.

“Melatonin is the second most common supplement given to children behind a multivitamin, so this is definitely a problem parents have,” said Dr. Viorritto. “I think most parents would agree they wouldn’t put their child on a prescription sleep medication without trying everything else first, and I would counsel the same approach before starting your child on melatonin.”

If your child has trouble falling or staying asleep, experts with the Pediatric Sleep Center at Wolfson Children's Stys Neuroscience Institute can help. Call 904.697.3600 to schedule an appointment.