It can be frustrating (and tiring!) when your child has trouble falling asleep at night. Many parents are turning to melatonin supplements as a solution. But what is melatonin? And is it safe for children?
Michelle Caraballo, M.D., Pediatric Pulmonologist and Sleep Medicine Specialist at Children's Health℠ and Assistant Professor at UT Southwestern, offers answers about melatonin and tips to help your child get a good night's sleep.
Why is a good night's sleep important for children?
Good sleep helps the brain function properly and helps to regulate mood, behavior and emotions. Sleep is important for everyone's health – but it's especially important for growing and developing kids.
"When children don't get enough sleep, we see both short- and long-term consequences," says Dr. Caraballo. "Initially, they may show symptoms similar to ADHD – attention issues, hyperactivity and learning difficulties."
Over the long term, poor sleep habits can lead to:
- Appetite issues
- Heart trouble
- Trouble with metabolism
- Weight gain
What is melatonin?
Melatonin is a hormone produced in your body that helps regulate your sleep-wake cycle.
"Melatonin is secreted from the pineal gland in response to dark exposure, whereas light exposure inhibits this mechanism," explains Dr. Caraballo. "When the sun sets and we turn down the lights, the brain releases melatonin. That makes us sleepy."
What are melatonin supplements?
To help children fall asleep, some parents turn to melatonin in supplement form as a sleep aid. However, Dr. Caraballo advises that most children without developmental or neurologic differences should be able to achieve healthy sleep without melatonin supplements.
If you've tried a healthy bedtime routine but your child is still not sleeping well, you can ask your child's pediatrician if melatonin supplements are right for your child. Melatonin supplements are available at pharmacies or health food stores and come in a variety of forms, such as:
- Extended-release capsules
- Oral dissolvable tablets
- Patches (also intended to be an extended-release formulation)
Is melatonin safe for kids?
Before giving your child melatonin, it's important to consult with your pediatrician. While studies show that short-term melatonin use in children is relatively safe, the American Academy of Pediatrics says more research is needed about its long-term use.
"Since melatonin is natural and we make it in our bodies, we think it's safe for short-term use under the guidance of a physician," says Dr. Caraballo. "For the most part, melatonin is well-tolerated. Many people use it with few side effects, if any."
Dr. Caraballo says parents should be aware that melatonin is sold as a nutritional supplement and not regulated by the U.S. Food and Drug Administration (FDA). "This means that the FDA does not check what's inside the bottle. The FDA has no oversight on its purity or accuracy of dosage," explains Dr. Caraballo.
Ask your doctor what brands and forms of melatonin might be best for your child. Some brands may have more studies supporting their safety and reliability of dosing.
Is melatonin safe for babies?
Melatonin is not recommended for babies. If your infant has trouble sleeping, talk with your pediatrician to find out why and work on a solution. There are many reasons your baby may have trouble sleeping that can typically resolve with time and attention.
What is a safe melatonin dosage for kids?
No large studies offer information about the appropriate dosage of melatonin for children. In her practice, Dr. Caraballo suggests:
- 1-3 milligrams for toddlers (over age 2) and preschool-age children
- 3-5 milligrams for school-age children and adolescents
- May consider increasing up to 10 mg in older adolescents
"We ask parents to start with a low dosage, according to age. And we carefully evaluate how effective it is," says Dr. Caraballo.
According to the American Academy of Pediatrics, many children respond to a low dose (0.5 or 1 milligram) when taken 30 to 90 minutes before bedtime. Ask your pediatrician for guidance about dosage and timing.
Are melatonin gummies effective for kids?
Kids like gummies, but if you don't see results using melatonin gummies, Dr. Caraballo has a suggestion: "We think the absorption is less reliable with the melatonin gummy formula. Instead, we suggest the dissolvable tablet or liquid formulation over the gummies. Sometimes that makes a difference."
Are there any side effects of melatonin for kids?
Melatonin can have potential side effects that might include:
- Increased bedwetting
- Low blood pressure
- Potential interaction with medications, including medications for immune disorders
- Upset stomach
Also, since melatonin is a hormone, more studies are needed to determine how its use might impact the onset of puberty. In Dr. Caraballo's practice, reported side effects of melatonin are rare.
Is it possible to overdose on melatonin?
Some children who take too much melatonin may experience side effects. More research is needed about the use and dosage. And, of course, it's important to keep melatonin and all medications out of the reach of children.
What other ways can you help your child sleep well?
To help your child sleep well, the most important thing you can do is establish a bedtime routine – and be consistent. "Kids really respond well to routine. Their bodies know what to expect," says Dr. Caraballo.
Other tips to encourage your child to sleep include:
- Turn off all electronics, television and radio 1-2 hours before bedtime
- Keep bedrooms cool, dark and quiet (Darkness cues the brain that it's time to sleep.)
- Read books, sing a bedtime song or say bedtime prayers
- Run a white noise machine or fan (if your child does not like total silence)
- Snuggle – but be sure your child has the skill of falling asleep independently. It helps to leave the room when they're drowsy but still awake.
If your child is still not sleeping well, melatonin may be an option – but it's a decision that should be made with the guidance of your pediatrician. With consistency, patience and time, hopefully you and your child will be on track to a good night's rest.
If you're concerned about your child's sleep habits, talk with your pediatrician. Our Sleep Disorders Center at Children's Health treats all forms of pediatric and adolescent sleep issues.
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