Over the last few months, as school morphed into remote learning which then turned into a COVID19-tainted summer, bedtime has taken a toll. Ever-changing schedules, plus perhaps excess screen time, has meant many kids (and adults too) are having trouble sleeping. And for many families, the go-to answer for readjusting to a normal bedtime is the over-the-counter natural sleep-aid melatonin for kids. Indeed, melatonin is widely used, but is it safe for kids?
What is melatonin?
Melatonin, a naturally occurring chemical in the body, is a special sleep-inducing hormone that helps regulate our sleep/wake cycles, Harvey Karp, M.D., pediatrician and author of the best-selling parent guides, Happiest Baby on the Block & Happiest Toddler on the Block, explains. “When it gets dark, our pineal gland (a tiny structure deep in the brain) gets the O.K. to release melatonin, which makes us drowsy. Daylight sends the opposite signal: it tells the pineal gland to shut off the melatonin, so that we can be bright-eyed and energized,” says Dr. Karp
Unlike many sleep-aids, the Mayo Clinic reports, users are unlikely to become dependent on melatonin, have a diminished response after repeated use (habituation) or experience a hangover effect.
Is melatonin safe for kids?
Most medical organizations, including the National Institutes of Health (NIH), agree that melatonin is safe for short-term use in kids—although you should always consult a pediatrician before using it. Dr. Karp says that when it comes to dosage, generally less is better. “In some cases, a doctor might recommend melatonin for a toddler,” he says. “Typically, a standard dose for young tots is 0.5 to 1 mg, given an hour before lights-out.” Research has shown that upping the dosage doesn’t necessarily equal more sleep.
Higher doses of melatonin (3 to 10 mg) tend to be reserved for children with medically related sleep issues, such as blindness, autism, or ADHD, Dr. Karp notes. He also points out that like many medications, melatonin has possible side effects including drowsiness, headache, dizziness, increased urination, bedwetting, and agitation.
How long should kids use melatonin?
While it’s safe for kids to occasionally take melatonin, the NIH cautions parents against long-term use. Because melatonin is not regulated by the FDA, it does not undergo the same rigorous testing and requirements for approval that prescription medication does. Dr. Karp says this makes it hard to guarantee the purity of the melatonin you buy.
Pediatrician Rosemary Prince, M.D. of ProHEALTH Pediatric Urgent Care of Yorkville, agrees. “There are many variabilities in the ingredients and formulations of these over-the-counter products, so you don’t always know how much of what you might be taking,” Dr. Prince says.
Another reason for caution: There are few large studies or long-term research into the effects of melatonin in kids, and a 2017 study found that there are multiple cases of supplement mislabeling.
Should parents give their kids melatonin?
First and foremost, consult your pediatrician about using melatonin. She can recommend a trusted formula, the right dosage for your child, and when and how often to use. A pediatrician can also help treat underlying disorders that may be related to lost sleep or offer recommendations for various sleep solutions.
Dr. Karp also advises parents to avoid melatonin until all other options are exhausted. “It’s not something you want to use after one bad night, for example. If your tyke is struggling with sleep, I’d recommend trying other methods (including a consistent routine, the use of sleep cues, and cutting off screens an hour before bed), before turning to a supplement,” says Dr. Karp. Check out Dr. Karp’s website, happiestbaby.com
Shana Liebman is the features editor of NYMP. She’s a writer and editor who has worked for magazines including New York Magazine, Salon, and Travel & Leisure—and she is the mom of two energetic little boys.