Is melatonin safe for kids?

The answer is complicated. Are you surprised? 🤪

The Canadian Sleep Society estimates that up to 25% of children suffer with sleep concerns (related to getting or staying asleep) and this number increases to 50-75% of children with physical or neurolodevelopmental concerns.

Infants experience polyphasic sleep cycles and it is developmentally NORMAL for them to wake multiple times in the night until sleep cycles consolidate with age. Children are considered able to “sleep through the night” if they can sleep a 6 hour stretch. So if bedtime is at 7 pm and they wake once somewhere around 1-2 am but then go back to sleep until morning, then they technically slept through the night. This actually also happens to adults but in most cases, we might just roll over in bed and have no memory of it. 😉

Melatonin use in kids has gone up and misuse has led some countries to ban the sale of over-the-counter melatonin. A prescription is required to purchase melatonin in Japan, some areas of Europe, and the UK, while in Australia, OTC melatonin was just recently made available but only at a specific dose.

Technically speaking, melatonin safety limits have NOT been established for general use in the PEDIATRIC population to treat insomnia. Risks and adverse events have not been studied for longterm use in kids.

Most studies on melatonin use in kids have been done on children with neurodevelopment disorders (Autism, ADHD, cerebral palsy, etc.). For the sake of this discussion, we are going to review melatonin use for kids WITHOUT known neurodevelopmental concerns.

🇨🇦Health Canada has stated that melatonin use in kids is considered “off- label” and they advise AGAINST melatonin containing products for children.

❗️Recommendations on off-label melatonin use for this age group should only be done under the guidance of a qualified practitioner!

❓What are the potential concerns with the use of melatonin for children?

The risks and side effects are largely unknown (as previously stated) and have not been studied. Some of the concerns that still need to be established include the short-term impact on psychological development and the long term impact on growth/development.

More specifically, researchers have reported concerns that melatonin could affect children’s hormonal development (ie. puberty, menstruation or prolactin levels), which may cause breasts or induce lactation.

Internationally, the most common side effects of melatonin misuse reported from the pediatric population include:

❗️Headache/ nightmares

❗️Confusion/ drowsiness

❗️Agitation/ anxiety

❗️Bed-wetting/ sleep walking

❗️Blood pressure changes

❗️Rarely, vomiting or seizures

Among the few randomized controlled trials that were done on melatonin in the pediatric population, the results found that melatonin only decreased the time it took to fall asleep from somewhere between 11 to 51 minutes… and the sample size was small. 😕

So if melatonin isn’t recommended for general longterm use in the pediatric population, what’s a parent to do?

✨ L I F E S T Y L E strategies are the number one recommended treatment option for pediatric insomnia in children without neurodevelopment or physical concerns! Lifestyle & behavioural interventions are effective, safe, and favoured by parents/caregivers. Luckily, we have SO MANY strategies that can address this! 🥳 Talk to your healthcare team, we’re here to help.

SPOILER… lifestyle strategies are also essential for treating adult sleep concerns even if melatonin is part of the plan. 😉

Now, this doesn’t mean melatonin cannot ever be used in the pediatric population. All that the guidelines are suggesting is that it is important to consult with a qualified provider to establish a dose and timeline on how much and how long melatonin might be used for, figuring out if there’s a DIFFERENT reason why your child isn’t sleeping (mouth breathing, anxiety, iron, screen-time, nutrition, sugar intake, etc.) while also addressing appropriate sleep hygiene rituals with your kids. Sleep problems in kids are not just a melatonin deficiency!

Hope this was helpful - Sleep tight 😴

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