Melatonin and Kids
Melatonin is the supplement of choice for many adults who have trouble getting quality sleep. Lately, perhaps in response to COVID-related stress and insomnia, children and teenagers are following suit (with help from mom and dad). This trend aligns with a spike in melatonin-related calls to poison control centers and hospitalizations in the United States, according to a recent report from the Centers for Disease Control and Prevention.
So, is melatonin safe for kids? We spoke with pediatric neurologist Arezou Heshmati, MD, to find out.
Melatonin is a hormone. The brain produces melatonin in response to darkness: more when it’s dark out (night) to help you sleep, less when it’s light (day) to help you wake up. Melatonin regulates the circadian clock and promotes quality sleep.
Melatonin is also designated as a dietary supplement in the United States and is available without a prescription. It’s found in different formulations of varying strength, purity, and efficacy, and it is not regulated by the FDA. When people have trouble sleeping, they take melatonin supplements to add to what the body normally produces.
Usually and most effectively it’s used for short-term sleep disorders, such as jet lag.
Is melatonin safe for kids?
Melatonin is generally well-tolerated, but there are few studies on melatonin supplements and children. When melatonin is given to children, sleep behavior strategies should also be part of the treatment. The goal should be to take the lowest dose possible for the least amount of time. Talk to your child’s doctor to determine what’s best.
Because melatonin is a hormone, taking supplements could theoretically affect hormonal development. There have been questions about melatonin’s effect on puberty, but research is not conclusive. Ask your child’s doctor about potential adverse effects and long-term safety data.
How much melatonin should you give a child?
There are no clear-cut dosing guidelines for melatonin. Typical dosing ranges from 0.5 to 10 mg, 30 to 60 minutes before the desired bedtime. Talk to your child’s doctor to determine the best dose for your child.
What happens if a child takes too much melatonin?
Data on the adverse effects of melatonin are limited. The exact toxic dose has not been determined, but large amounts can cause toxicity.
Symptoms of melatonin overdose include headache, nausea, vomiting, diarrhea, and agitation, and melatonin overdose can lead to suppression of breathing and coma.
How do you get a kid to sleep without melatonin?
Teaching good habits—such as having a consistent bedtime and wake-up time, using no electronic devices one hour before bedtime, getting regular physical activity, and limiting caffeine—should always be the first line of treatment for insomnia in children.
If you've tried improving habits and your child still cannot fall asleep until very late, talk to your pediatrician or a pediatric sleep disorders specialist for guidance. There are no FDA-approved medications for insomnia in kids of any age.
At what age can kids take melatonin?
We need more research to say definitively, but melatonin is typically not given to children under 2 years old.
Can kids get addicted to melatonin?
There is no report of addiction to melatonin.
How long does melatonin last in a child?
Like other drugs and supplements, a person’s metabolism determines how long something works and stays in the body. Ask your pediatrician how to determine the best dosage schedule for your child.
Arezou Heshmati, MD, is associate professor of neurology in the Division of Child Neurology at Columbia University Vagelos College of Physicians and Surgeons and an attending physician at NewYork-Presbyterian Hospital. She is board-certified in pediatrics, sleep medicine, and neurology with special qualification in child neurology.
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