As bedtime approaches, it’s easy to understand why harried parents of young children may consider giving them flavored melatonin drops or gummies, which are specifically intended to help kiddos sleep.
Melatonin supplements are available in the supplement aisle of almost every pharmacy and are marketed to parents everywhere. There are people on TikTok who promote their use in kids, while others say not so fast.
So is it really a good idea to give a synthetic hormone to babies, toddlers, or even adolescents in the search of a better night’s sleep for them and by extension, yourself? Here’s what you should know before you try it. (Keep in mind that supplements should be stored out of reach just like any medication; there have been melatonin-related overdoses and deaths in children.)
What is melatonin, exactly?
Melatonin is a hormone produced by the pineal gland, which is lodged deep in the center of the brain. The hormone rises and falls in sync with night and day.
“Melatonin is triggered by light and dark,” said Dr. Steven H. Feinsilver, director of the Center for Sleep Medicine at Lenox Hill Hospital in New York City. “The response of the normal brain in the dark or the evening is to produce more melatonin which [facilitates] sleep onset.”
The light of day suppresses melatonin production, easing you into wakefulness.
Melatonin supplements are designed to mimic the natural hormone. While quite a bit is known about melatonin supplements in adults, it’s less studied in kids. However, experts agree that they should not be given to children under age 3.
Before you give a child melatonin, talk to their doctor first
The American Academy of Pediatrics recommends that parents try melatonin supplements for their children only after talking with a pediatrician. That way, they can investigate whether the child has a medical disorder that’s interfering with sleep.
“Melatonin may not be the right approach for some underlying sleep problems like sleep apnea and restless legs syndrome,” said Dr. Kori Flower, a professor of pediatrics at the University of North Carolina School of Medicine.
And it may not be right if the insomnia is caused by an infection or identifiable anxiety, like a looming test at school.
Why melatonin supplements are a bad idea for babies
If you are considering giving a child melatonin, again, they need to be at least 3 years old, said Dr. Shalini Paruthi, a spokesperson for the American Academy of Sleep Medicine.
Children under age 3 have relatively unformed neurological and endocrine systems, Paruthi said.
“The best strategy for young children and infants is to help them to have their own brains produce their own melatonin,” Flower said. “The best thing is to rely on their own bodies.”
Look for behavioral solutions first
For older kids, you may want to try behavioral and “sleep hygiene” measures before turning to supplements.
It helps to establish a bedtime routine for your child. That means going to bed and waking up at the same time every day and removing phones, tablets, TVs, and computers an hour before bedtime.
“This is really hard but really important,” Flower said. “The blue light will suppress the production of melatonin and the stimulation from the electronics continues to occur in the brain after the devices are shut off.”
Kids should also get plenty of exercise earlier in the day and avoid caffeinated snacks and drinks (including soda, some types of chocolate, and sweet tea). Older children may need less sleep so it’s OK to skip a nap after school if they sleep better at night.
Melatonin supplements may be a short-term solution
The AAP says that melatonin supplements may be used in the short term for children with sleep problems.
This is based on limited research showing melatonin might speed up sleep onset and help kids sleep longer. The biggest gains were seen in studies of children with autism and other neurodevelopmental disorders, although the hormone doesn’t affect core symptoms.
“There is a subset of children on the autism spectrum disorder who may benefit from a small dose of melatonin,” said Paruthi, who is also co-director of the Sleep Medicine and Research Center at St. Luke’s Hospital and adjunct associate professor at the Saint Louis University School of Medicine. “Studies do show that up to 40% to 80% of children on the autism spectrum may have insomnia. Research shows that they can have problems in their pathway of producing melatonin in their brain.”
Small doses of melatonin in the evening along with bright light in the morning may help postpubescent children with delayed sleep-wake phase disorder (for example, a teenager who stays up late and sleeps in until the afternoon), Paruthi said. In both cases, melatonin should be given with a doctor’s supervision.
Start with low doses
No one knows exactly how much melatonin is the right amount, so if you decide to try melatonin supplementation, start low.
“If a parent has noticed that their child is having great difficulty falling asleep despite excellent sleep hygiene and a great bedtime routine, it may be reasonable to purchase over-the-counter melatonin, and try 1 to 3 mg for up to one or two weeks,” Paruthi said.
If the sleep problems persist for longer than about two weeks, follow back up with your pediatrician.
Pay attention to formulations as well. While “immediate-release” versions may help you fall asleep, they don’t necessarily keep you asleep through the night.
Is melatonin safe for kids?
Most of the studies into melatonin in children have only looked at it for short periods of time. At least for temporary use, the research indicates that it’s generally safe, though it can cause side effects like headaches, dizziness, agitation, and bedwetting. All of these tend to go away when the melatonin is stopped.
People have expressed concern that long-term use of melatonin supplements may delay sexual development when given to prepubescent children, but there’s not enough data in humans to confirm or deny this.
One thing we do know is that melatonin can interact with anti-seizure medications and blood thinners, which is another reason to consult a healthcare professional.
You may not be able to trust the products
Even though supplements are widely available, remember that the Food and Drug Administration does not regulate supplements like it does prescription medications. That means you may not know exactly what you’re getting when you buy an over-the-counter product.
One study of 31 products found that almost three-quarters contained melatonin content at least 10% greater or lower than claimed on the label. Sometimes the melatonin content was as high as 478% above the label. About a quarter of products also contained the mood-altering hormone serotonin.
“It’s important to recognize that melatonin is not regulated by the FDA,” Paruthi said. “Therefore, there is no guarantee that the melatonin you find between brands, between bottles, or between tablets/liquid is equivalent.”
The bottom line
The take-home message is don’t give melatonin supplements to babies, but it may sometimes be appropriate for older kids.
“Melatonin in low doses for a short amount of time may be safe for some children,” Paruthi said. “Unfortunately, there is a lack of large randomized controlled trials across the different development stages in children, so at this time, we are not able to definitively say which children will benefit from melatonin and how safe it is in terms of possible short-term or long-term side effects.”
In other words, parents and caregivers should use melatonin supplements with caution and talk to their doctor first.