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Published on July 09, 2019

toddler girl on couch in pajamas holding stuffed toy

Melatonin, Kids and Sleep

When the sunlight fades and nighttime returns, a tiny gland in our bodies begins secreting a substance that makes our eyelids heavy and our thoughts turn to pillows and pajamas.

Melatonin is a natural hormone that helps with sleep, but we can make it in labs and use it to help people – especially children – get to sleep faster and more soundly.

But should we?

“Some studies show that not all kids produce melatonin at the same rate, especially in children with certain neurological conditions,” said Emily Murray, PharmD, a clinical pharmacist at Avera McKennan Hospital & University Health Center. “In those cases, it can be an effective, safe aid for helping them sleep. For most kids, it can be used occasionally, especially when they are traveling or out of their comfort zone and sleep is elusive.”

Melatonin is an over-the-counter medication, but not all varieties are the same. Murray said quality matters, and that savvy shoppers will look for varieties with the United States Pharmacopeial Convention (USP) seal. “It’s like a USDA quality seal for supplements and should be considered when purchasing, to make sure you get the best quality,” she said. “It’s important in many supplements.”

While occasional use is not a big deal, regular use for longer time frames, like a month, can be troublesome.

“If a child is experiencing difficulty falling asleep for a period of weeks, there may be an underlying cause,” Murray said. “So talking to your pediatrician about that – long before kids use it for that long – is a great idea. They can look for the reasons behind the difficulty getting to sleep.”

Melatonin can lead to some next-day drowsiness, but overall it is a safe substance for most kids. Children with conditions that include seizures should not use it before mom and dad first speak with their provider. In addition, children prescribed attention-deficit medications may benefit from adjusting the dose or timing of that medication before adding a supplement like melatonin.

“There have not been exhaustive studies on the use of melatonin in part because there are just fewer studies done with children in general,” said Murray. “It’s seen as a ‘likely safe’ substance and is even available in liquid form. Daily doses of melatonin should be limited to three milligrams for children and infants 6 months and older and five milligrams for adolescents.”

The biggest worry Murray poses about the substance is its long-term use.

“If it is used too regularly for too long, melatonin could be masking an underlying issue, and if it’s hiding it from mom and dad, it could be hiding it from a provider, too,” she said. “In general, it’s most often a good tool to help kids from time to time, but not something that should become an every-day part of their routine without first having a conversation with their care provider.”

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