The question of whether it’s ok to give children Benedryl to help them sleep is a regular question that I field in my office. I got it again this week. I figure for the number of times that a parent actually asks me the question, there has to be significantly more who are just doing it and not asking if it’s ok.
The short answer to the question is: NO. It is not a good idea to drug a child to get the child to sleep. The cute mom who asked this past week protested. “But, it’s working,” she said. (Her child had previously struggled with awaking multiple times a night). And while Benedryl may make your kid sleep better (temporarily), it can create much bigger problems.
Pitfalls to Benedryl
Benedryl, like all medications, has side effects. One of the side effects, sleepiness, is what the medication is used for in this case. However, parents don’t consider the other potential side effects (albeit, far less common):
- Blurred vision
- Poor coordination
- Inability to pee
- Dry mouth
- Heart problems (including fast rate, extra beats, and pounding)
- Upset stomach
The list of side effects is 3 times longer, I just chose a few to mention.
The other problem with using a medication to sleep (whether it’s Benedryl, Melatonin, or other) is that the child doesn’t learn the very important skill of putting him/herself to sleep. No one ever considers sleeping as a skill, but many kids have to be trained to acquire appropriate sleep habits and patterns. It is important that a child learn how sleep (independent of medications) right from the get-go.
I’m already giving it, so now what?
Stop. Don’t replace one bad habit with another (don’t give something else instead). Pull off the proverbial Band-Aid and just know it’s going to hurt for a short while. In the beginning, your child will likely struggle to go to sleep. Hang in there, it’s well worth the training. Look for pointers on helping sleep-train your child in Wednesday’s post.
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.)
I saw a teenager this last week in clinic with a really common complaint: “I can’t sleep.” He has trouble falling asleep at night, can’t get up in the morning, and is dying tired when he gets home from school. So, he takes daily naps. The problem is clear to you and me, but never to the teen.
STOP TAKING NAPS!
The teen’s reply is always the same, ‘But, I’m so tired. It’s the only way I can get by.’ The teen doesn’t realize that the naps are at the root of the problem. It’s poor sleep hygiene. To fix the sleep problem, go to bed at the same time, wake up at the same time, and don’t sleep during the day. It’s that simple. (The only exception is kids under 5 years and those who are ill).
-Photos courtesy of www.123rf.com
Infants have a very unique sleep pattern and must get adequate sleep for proper brain development. Having a good understanding of healthy infant sleep can help everyone in the household sleep better.
Why is infant sleep important?
An infant’s brain is still developing. When born, an infant’s visual system and other systems are not fully developed. Sleep plays an important role in proper development and learning.
If my baby needs so much sleep, why is he/she having such trouble falling asleep?
Just as in adults, the need for sleep doesn’t drive your ability to fall asleep. Everyone has experienced at sometime or another being exhausted, but not being able to sleep. There is also a natural sleep-wake cycle (or circadian rhythm) in all of us. Infants have a 90-minute alertness rhythm as well. After 90 minutes of being awake and alert, an infant will have a small window of sleepiness. If the infant is not put to sleep during that window, then he/she will proceed to the next alert phase.
How do I know if my baby is sleepy?
- Mood: If your baby is crying, fussing, or whining without a obvious cause
- Attention: If your baby suddenly loses interest in an activity, won’t engage socially, or has a spacey facial expression
- Actions: If your baby is eye-rubbing, yawning, falling down, or repeatedly dropping held items
How do I know if my infant is getting enough sleep?
Signs that your baby may be sleep deprived include:
- Your baby always falls asleep in the car, stroller, or swing
- Your baby can only fall asleep in the car, stroller, or swing
- Your baby only catnaps (20-30 minutes at a time)
- Your baby sleeps less than 3 hours total during the day
How to help your infant sleep
In the first couple of weeks of life you may have noticed or even championed the fact that your baby could sleep through everything. It is common and normal for most infants in the following 2-4 months to require “help” getting to sleep. You may have to hold, rock, or sooth your infant to sleep. By about 4 months, most babies start to learn how to block things out in order to sleep.
When should my baby sleep through the night?
There is no magic age or weight when your baby will sleep through the night. Most babies sleep through the night somewhere between 5 and 7 months of age. Some do it on their own, while some require intervention. All babies wake at night, the difference is that not all cry out and require help getting back to sleep.