Why I Don’t Recommend Melatonin Use in Kids

I get a lot of parents asking me about melatonin use in kids and whether or not it is something I recommend. The answer I give parents is that no it is not something I personally recommend.

First of all, I’m not a doctor so I don’t recommend the use of medications or supplements without the approval or recommendation from a doctor. However, the biggest reason is because research shows that the best first step to address children’s sleep issues is in sleep hygiene and lifestyle changes. And that is what I help parents with every day. But let’s talk more about melatonin use in kids and whether it is safe and effective as well as things you may be able to try instead. 

What is melatonin?

Melatonin is a hormone that is naturally produced and released in the body by the pineal gland. It helps control the body’s circadian rhythm and is secreted in response to decreased light. Luis F. Buenaver, a sleep expert at John Hopkins states that “most people’s bodies produce enough melatonin for sleep on their own.” ¹

Melatonin doesn’t exactly make you go to sleep but it promotes sleep by putting you into a state of quiet wakefulness that then you can easily go to sleep from, according to Buenaver.

What is the root cause?

When it comes to the root cause of sleep issues in children, not having enough melatonin production is likely not the reason. (In infants younger than 2 months old, their bodies are still developing circadian rhythmicity and are programmed to eat and wake frequently around the clock so we are going to leave them out of this discussion.) 

Research suggests that in infants and toddlers behavioral factors, sleep hygiene and fears (for toddlers and older) should be assessed and addressed first because an organic cause of insomnia is unlikely in the scenario of a child with normal growth and development.² 

Is melatonin use in kids dangerous?

In short, no it has not been shown to be dangerous for short term use in children. This review stated that there is no evidence available to support the use in children younger than age two.³ However, it also recognized that there are significant limitations on the studies done to support melatonin use.³ The long term safety and efficacy of melatonin has not fully been established either. ²

Overall if you have given your child melatonin to help them get to sleep, the information we have currently does not show it to necessarily be dangerous. However, especially for children with other health issues, a doctor should always be consulted. It can be contraindicated for those with certain disorders and medications.² Additionally, the Food and Drug Administration has not approved melatonin for use in children as a sleep aid.⁴

Is melatonin use in kids effective? 

The studies that have been done show that the use of melatonin when timed and dosed appropriately can help children fall asleep faster at the initial onset of sleep. However since melatonin does not actually cause you to fall asleep, it just helps promote sleep, the use of melatonin won’t necessarily get your child to sleep all night. 

For short term use in older children it may be helpful in resetting sleep schedules. ⁴ 

Helping your child’s body work optimally

Since sleep hygiene and behavioral measures are shown to resolve a majority of sleep challenges in young children, here are some things you can do to help your child’s body work optimally producing and releasing melatonin. 

Melatonin is released in response to decreased light and darkness, this is one of the most important things you can do to help address sleep hygiene issues. 

• Make sure the sleep environment is DARK (or as dark as possible for children with fears who need night lights). 
• Dim lights 30 to 60 minutes prior to bedtime. 
• Discontinue use of screens about 2 hours prior to bedtime. 
• Provide ample outside time or time with natural light and fresh air to help regulate your child’s body clock.

Why I don’t recommend melatonin use

I work with many parents who come to me because their pediatricians have recommended melatonin but they either don’t like giving it to their child or it has not really fixed the sleep issues they were having. Sometimes both. 

Working with these parents to improve sleep hygiene and addressing any behavioral components we are almost always able to get otherwise healthy children sleeping well without the use of melatonin. We go from kids taking hours filled with fights and battles to fall asleep to falling asleep peacefully, easily and in a reasonable amount of time! 

If you are in a similar situation and aren’t sure what to do to because you want to discontinue or avoid starting melatonin, you can schedule a free evaluation call with me here. We can chat through what is going on and I can share how I may be able to help you and your child establish healthy sleep habits and hygiene to get your child sleeping well without the use of melatonin!

To healthy and happy sleep,

Bonnie

¹ https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work

² https://pubmed.ncbi.nlm.nih.gov/12897290/ – Sleep Related Melatonin Use in Healthy Children 

³ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380753/?report=reader – Melatonin for the Management of Sleep Disorders in Children and Adolescents. 

⁴ https://www.healthychildren.org/English/healthy-living/sleep/Pages/Melatonin-and-Childrens-Sleep.aspx