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 Associate Professor at UT Southwestern, offers answers about melatonin and tips to help your child get a good night's sleep.
What is melatonin?
Melatonin is a hormone produced in your body that helps regulate your sleep-wake cycle.
"When the sun sets and we turn down the lights, the brain releases melatonin. That makes us sleepy," explains Dr. Caraballo.
Some parents turn to melatonin supplements to help their child fall asleep. 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 about melatonin supplements. Melatonin supplements are available at pharmacies or health food stores and come in a variety of forms, such as:
- Extended-release capsules
- Gummies
- Liquids
- Oral dissolvable tablets
- Patches (also intended to be an extended-release formulation)
- Tablets
Are melatonin gummies effective for kids?
Melatonin gummies are generally considered safe and effective for kids when used correctly. However, they may not work well for all kids. 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 formulation. Instead, we suggest the dissolvable tablet or liquid formulation over the gummies. Sometimes that makes a difference."
How safe is melatonin for children?
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 regulated by the U.S. Food and Drug Administration (FDA) as a nutritional supplement and not as a drug. "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.
One study of 31 different melatonin supplements found that the actual dosage of melatonin can vary widely even within one bottle – sometimes a lot more and sometimes a lot less – than what was listed on the label. 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.
Are there any side effects of melatonin for kids?
Yes. Melatonin can have potential side effects that might include:
- Drowsiness
- Dizziness
- Headache
- Increased bedwetting
- Irritability
- Low blood pressure
- Nausea
- Upset stomach
- Potential interaction with medications, including medications for immune disorders
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 experience, reported side effects of melatonin are rare.
Can melatonin cause behavioral issues in kids?
While potential behavioral side effects have not been rigorously studied, Dr. Caraballo has not seen this as a concern or common complaint in her practice.
Since children typically go to bed shortly after taking melatonin and the effects of most formulations wear off by morning, it is not expected to adversely impact behavior.
It is more likely to anticipate improved daytime behavior because of improved nighttime sleep.
Is melatonin safe for newborns and toddlers?
Melatonin is not recommended for children under the age of 3. At this age, children may have trouble sleeping for many reasons and they often resolve naturally with time. If your infant or toddler has trouble sleeping, talk with your pediatrician to discuss why and how you might help your child improve their sleep habits.
What is a safe melatonin dosage for kids?
More research is needed to better understand the appropriate dosage of melatonin for children. In her practice, Dr. Caraballo suggests:
- 1-3 milligrams for toddlers and preschool-age children (if your child is under age 3, discuss with your pediatrician before using melatonin)
- 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.
Many children respond to a low dose (1-5 milligrams) when taken 30 minutes before bedtime. Ask your pediatrician for guidance about dosage and timing.
Is it possible to overdose on melatonin?
While uncommon, it is possible to overdose on melatonin. Signs of a melatonin overdose include vomiting, rapid heart rhythm and low blood pressure. If you suspect a melatonin overdose, seek medical attention right away.
Calls to poison control centers regarding melatonin overdose increased by more than 500% from 2012 to 2021. Most children whose families contacted these centers did not need to be hospitalized. Overdoses were often accidental, when a child got ahold of melatonin supplements – especially gummies which can be mistaken for candy. That’s why it's very important to keep melatonin supplements and all medicines out secured and out of a child’s reach.
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."
When kids don't get enough sleep, they can be irritable and moody. Unlike adults, children with poor sleep or inadequate sleep are less likely to present with daytime sleepiness.
Over the long term, poor sleep habits can lead to:
- Appetite issues
- Heart trouble
- Trouble with metabolism
- Weight gain
- Higher risk of high blood pressure, diabetes and stroke
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.
Learn more
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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