If your child is having trouble sleeping, the quick fix of melatonin may not be a permanent, or good, solution.
Stephanie Hanson, M.D., a pediatrician at Sanford Health in Fargo, North Dakota, said part of the issue with melatonin, a popular over-the-counter sleep aid and substance your brain naturally produces, is that it’s not FDA regulated.
According to the National Institutes of Health, the FDA does not regulate supplements, including melatonin. They do however regulate prescription-strength melatonin, commonly used to treat insomnia.
What you see isn’t always what you get
Dr. Hanson stated that without “the strict monitoring we would see with other medications like ibuprofen or a cold medicine,” there’s no way to know exactly how much melatonin you are, or aren’t, getting.
“It might be labeled as three milligrams, but there could be six milligrams in there, or one milligram in there. What you see is not necessarily what you get,” she explained.
Dr. Hanson also said some other substances, like diphenhydramine (Benadryl) or CBD, could also be present in melatonin products since there is no strict FDA regulation.
A research study from the Journal of the American Medical Association suggests the same:
- 88% of melatonin products were inaccurately labeled (22 out of 25).
- Actual amounts of melatonin ranged from 74% to 347% of the labeled quantity.
- Three products out of 25 contained the advertised amount of melatonin.
- One product did not contain any melatonin but instead contained 31 mg of CBD.
“Those substances are things you might not necessarily want to administer to your kids,” Dr. Hanson said.
Don’t interrupt what your body already does
Remember, your brain already produces melatonin naturally. Melatonin is a hormone produced by the pineal gland. When your body produces melatonin, it’s signaling bedtime.
Sometimes this signal can get disrupted because we ourselves disrupt it, according to Dr. Hanson.
“Too much screen time can impair your body’s production of melatonin. Lack of exposure to sunlight can also do it, same with erratic or irregular bedtime schedules,” she said.
Dr. Hanson recommends “getting back to basics” when it comes to improving your child’s sleep.
Getting back to basics includes:
- Limiting screen time for at least an hour before bed
- Creating a consistent bedtime routine
- Having a dark, quiet sleep space
- Eating well and getting enough exercise
She said she understands why parents would look into melatonin as a sleep aid for their children.
“We’re all tired, we’re all chronically overworked, schedules are tight. It takes a lot of parenting effort to get your kids on a regular routine, so I don’t blame people who are looking for anything out there to give them a little assistance in that area,” Dr. Hanson said.
Overdose is possible
According to Dr. Hanson, even though melatonin is a substance our body naturally produces, she’s seen overdoses in children.
“In about a 10-year span, from 2012 to 2021, there were 260,000 cases of child poisoning involving melatonin (in the United States). Most of the time kids do fine and they don’t have any long-term problems, but there were some kids who needed to be admitted into the hospital. Two kids died as a result of melatonin poisoning,” she said.
“We just don’t know the long-term effect of melatonin use. Again, there’s nothing jumping out at us immediately as like, ‘this is immediately dangerous for you,’ but it’ll be interesting to see. It’s so widely used,” she added.
Overdose symptoms include extreme lethargy, unresponsiveness, and trouble breathing.
“I would say that some of the more common things people report to me when their kids are taking melatonin is difficulty waking up in the morning, nightmares or disrupted sleep, you know, later on in the night, or bedwetting,” she said. “Those are some things that can kind of come as a result of melatonin use.”
Work with your primary care provider
If your child is having trouble sleeping, Dr. Hanson said the best place to start is with your primary care provider.
“They’re going to understand what your child’s specific health situation is and be able to refer you on,” she said. “Maybe they need a behavioral health provider on board, or maybe a sleep medicine doctor would be a better tool and be able to do a sleep study. We can do sleep studies at Sanford on kids of any age.”
Parents and caregivers should always consult their child’s primary care provider before giving their child melatonin in order to determine what dosage, if any, is appropriate.
Talk with your child’s provider to see if there are any other issues that might be causing your child’s sleep difficulties.
Learn more
- Children’s primary care at Sanford Health
- Sleep matters at all ages, for some surprising reasons
- Is your baby getting all the sleep needed? Are you?
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Posted In Children’s, Healthy Living, Nutrition, Sleep Medicine
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