There isn’t a week that goes by that I don’t field a question about whether or not to use Melatonin in kids. In case you haven’t heard, Melatonin is a hormone secreted by the brain that helps regulate sleep. It can be purchased over the counter and comes in a variety of forms (pills, gummies, liquids, etc.). It’s claim is to aid in sleep. So, it is easy to see why tired parents are calling to see if it’s a viable option for their kids who have sleep problems.
The scientific facts
Melatonin is a hormone that is produced by the body’s pineal gland (in the brain). It is produced at night when it is dark. It is one of the few, if not only, hormone that is available in the US without a prescription. The US Dietary Supplement Health and Education Act of 1994 allowed it to be sold as a dietary supplement (because it is contained naturally in some foods). It is not regulated like most prescription medications by the FDA or subject to the same regulations as other hormones. It is by prescription only in Australia and most of Europe.
The scientific literature is hit and miss on effectiveness of melatonin. There are lots of studies to support it helps, especially true of those relating to helping people “reset internal clocks” such as with jet lag or shift work, and many to support it doesn’t work. The truth is that there are plenty to support both sides of the argument. It is generally thought to have few side effects, with the most common reported ones as grogginess, nausea, and irritability. To my knowledge (and searching the literature) there are no good, long-term scientific studies to demonstrate the long-term effects and safety in kids.
The short answer is that I don’t recommend it. I have never given Melatonin to my kids (and we’ve had our share of sleep problems over the years). With that said, I know lots of parents give their kids melatonin and have tried it, but I don’t love it. I worry that there is no scientifically established recommended safe dose. When people call me for a dose, I honestly don’t know what to tell them. The medical societies don’t give a recommended dose in kids. Since it is a “supplement” according to the FDA, there isn’t the same regulation on various brands/preparations. Consequently, there are variable concentrations and labeling differences which make interpretation very difficult. Furthermore, we (the collective medical world) don’t really know what the long term effects are and if it is safe (after all, hormones affect multiple organs in the body). Needless to say, it gives me a lot of pause. (As an aside, you may be interested to know that “all natural” melatonin comes from cow or pig brains, so I’d avoid that. Most preparations are now synthetic which would be preferable in my opinion.)