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The Blog

Melatonin Supplementation in Children: What You Need to Know

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melatonin; sleep; insomnia

Check out the PedsDocTalk YouTube Video: Melatonin Supplements and Children, for more information about melatonin including when it might be recommended, melatonin for time change or travel across time zones, side effects of melatonin, and safety recommendations.

Sleep is often a challenging area for many families. Whether it’s bedtime battles, frequent night wakings, or difficulties staying asleep, sleep disruptions can take a toll on both parents and children. For those looking for solutions, melatonin supplements often come up as a potential option. However, when considering melatonin, it’s important to understand how it works, how effective it really is, and what safety guidelines to keep in mind when using it with children.

What is melatonin?

Melatonin is a hormone produced by the pineal gland in the brain, and it plays a critical role in regulating sleep. It’s commonly known to help with sleep because it’s produced in response to darkness, so it naturally increases in the evening and helps to promote sleep at night. Melatonin’s role is more about helping you fall asleep rather than keeping you asleep throughout the night.

This hormone is connected to your body’s circadian rhythm, or internal clock, which helps regulate daily sleep-wake cycles. While melatonin is most commonly linked to sleep, research suggests it may have other functions in the body, though these roles are still being explored.

What are melatonin supplements?

Melatonin supplements are synthetically made to mimic the natural hormone produced by the body. They are often marketed to promote sleep – suggesting restful, relaxing or longer sleep. The melatonin available for children is often in the form of gummies, chewables, or liquids. These can be available over the counter (OTC) or by prescription.

What does the research say about melatonin use in children?

The research on melatonin supplements in children is still evolving. One systematic review and meta-analysis from 2023, which included 419 children and adolescents, found that melatonin helped increase sleep time by an average of 30 minutes and reduced the time it took to fall asleep by 18 minutes. While these results seem promising, the studies were small and often relied on self-reports. Therefore, results should be interpreted with caution.

A 2019 meta-analysis suggests that melatonin is effective in children with neurodisabilities, particularly autism spectrum disorder (ASD). It was also well tolerated, with few reported side effects. However, even in these cases, experts recommend using melatonin only after trying other sleep strategies first.

Overall, the research on melatonin use in children is limited. This is often the case for research in pediatrics. Therefore, there isn’t strong evidence to support the efficacy or safety of melatonin, and choosing to give it to your child may be done on a case-by-case basis.

When should you consider melatonin?

Before turning to melatonin supplements, it’s important to explore the root cause of your child’s sleep difficulties. There are medical or behavioral conditions to assess for and rule out, such as sleep apnea, ADHD, or anxiety. This PedsDocTalk podcast episode with Dr. Shelby Harris, a licensed clinical psychologist who is board-certified and specializes in behavioral sleep medicine, covers conditions that affect sleep and when to be concerned.

Additionally, ensuring good sleep hygiene is crucial. Overuse of screens and tablets can interfere with the body’s natural melatonin production. Other sleep hygiene considerations include bedtime routines, daily schedules, and parental approaches to sleep boundaries. The importance of sleep hygiene cannot be understated! For older children, sleep may also be affected by stress, screen time, physical activity or the lack thereof, and school events. 

If other causes for sleep issues have been ruled out and additional strategies to improve sleep have failed, melatonin might be recommended. According to the American Academy of Pediatrics (AAP), when dosing melatonin, it’s best to start with a low dosage and evaluate the effectiveness and side effects for your child. For more information on dosing, watch this PedsDocTalk YouTube video.

What about using melatonin for time changes? Or when traveling across time zones? This PedsDocTalk YouTube video answers your questions!

Potential side effects of melatonin

The most commonly reported side effects of melatonin include drowsiness and grogginess the next morning. It’s essential to be aware of possible interactions with other medications your child may be taking. Always talk to your child’s pediatrician or pharmacist to check for potential interactions before starting melatonin.

It’s generally accepted that melatonin is relatively safe for short-term use. However, there is less certainty about the long-term use. Therefore, benefits and risks should always be discussed with a child’s clinician, as the benefits of long-term use may outweigh any unknown risks.

Safety recommendations for melatonin

One key concern with melatonin supplements is the variability in product quality. In the U.S., supplements are not regulated by the Food and Drug Administration (FDA). This means there are likely no additional regulations or testing outside the company creating and selling the supplements.

A 2021 study found that melatonin content in gummies varied widely, with some containing up to 347% more than the labeled dose. This highlights the importance of choosing a trusted brand and discussing melatonin use with your child’s healthcare provider.

Accidental overdoses are another concern. One study reported that between 2012 and 2021, there were over 27,000 emergency room and clinic visits, over 4000 hospitalizations, over 275 ICU admissions, and 2 deaths from melatonin ingestion. Be sure to store melatonin out of reach of children to prevent accidental ingestion.

The takeaway

Sleep issues can be challenging, but the goal should always be to establish healthy habits that promote natural sleep. If your child continues to have trouble falling or staying asleep, consult their clinician for individualized recommendations. Melatonin may be a helpful short-term solution for some children, but it should always be used cautiously and under the guidance of a healthcare professional.

Watch the PedsDocTalk YouTube Videos HERE!

P.S. Check out all the PedsDocTalk toddler courses, including the Picky Eating Playbook, No-Pressure Potty Training, and Toddlers & Tantrums.

Dr. Mona Admin

Hi there!

I’m a Board Certified Pediatrician, IBCLC, and a mom of two.

I know the ups and downs of becoming a mom and raising kids.

I help moms ditch the worry and second-guessing so you can find more joy in motherhood.

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All information presented on this blog, my Instagram, and my podcast is for educational purposes and should not be taken as personal medical advice. These platforms are to educate and should not replace the medical judgment of a licensed healthcare provider who is evaluating a patient.

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All opinions are my own and do not reflect the opinions of my employer or hospitals I may be affiliated with.