I was surprised to find melatonin sleep aids made specifically for kids being sold over the counter – especially as I knew the side effects that melatonin can cause adults.
Not that the risk of side effects automatically excludes the medical world from recommending medication or supplements for kids.
But something seemed strange about the idea of sleep aids made especially for children.
An emotive issue
Shouldn’t children get sufficiently tired out from play and exercise? Isn’t there more that parents can do to help them sleep before giving them sleeping pills?
These are the kind of emotive questions that the idea of giving children melatonin, or any sleep aids for that matter, brings up.
Ideally, parents should consult their child’s doctor before giving them melatonin. They can tell you if it’s safe for your particular child, and if so, what dose to give them and for how long.
In this article, I’ll be examining some brands of melatonin to see how they are marketed to parents.
I’ll then discuss what sleep experts say about giving kids melatonin, and consider some of the common arguments for and against the idea.
Brands of melatonin made for kids
OZzzz’s Sleep Aid for Children
This is one of the best selling melatonin products for kids online. It contains 0.5mg melatonin and 2mg chamomile. It’s marketed as being fast dissolving and fruit-flavored so kids will take it.
It gets generally good reviews, but as you would expect, some parents say it didn’t work at all.
I was surprised to find out who makes it; on their website, they say it was developed by a mother who’s a registered nurse with help from her pediatrician – not a pharmaceutical company.
This brand has a lower dose, with just 0.3mg. It also has other herbal ingredients added to the mix, including Chamomile and Lemon balm.
It’s not clear from their website who manufactures it, though they say ‘at a lab’ in the United States.
I was actually impressed at first by their website. On their Q&A section they do state they agree with natural methods to help children sleep. And they also answer the question of whether melatonin is ‘drugging’ your child.
Then I discovered in their media section photos of a small boy holding 2 boxes of Tired Teddies with a big smile on his face.
I know you can’t judge the quality of a product from the manufacturers choice of promotion techniques. But something about the pictures seemed very strange.
NATURALLY ACTIVATES the onset of a healthy sleep pattern in children and adults
It’s also considerably stronger than the first 2 brands, containing 1 mg melatonin. On the extended description you find this ambiguous line explaining how many tablets people should take:
…up to 6 at bedtime (children should take less).
Even though Mel-O-Chew is produced by a larger company (Maxi Health), the lack of instructions for giving it to children is concerning.
What’s going on?
In some parts of the world, melatonin is classified as a dietary supplement, not a pharmaceutical drug.
That means it doesn’t need to be approved by strict organizations such as the Food and Drugs Administration. It’s also available over the counter in the United States, unlike most of Europe.
So it’s easier for companies to manufacture and sell it than many other sleep aids. And there’s currently nothing stopping them from marketing it for use by children.
Here are two more points to consider:
- Melatonin is the only hormone available in the US without a prescription.
- Because it isn’t regulated by the FDA, the factories and labs making it aren’t either.
What do medical professionals say?
A report by the Guardian newspaper
In 2017, the Guardian published an interesting article on melatonin, with eye-opening opinions of sleep experts in the U.K.
They make the point that sleep experts are concerned by the rise in the number of parents giving melatonin to their children. They quote Dr Neil Stanley as saying:
Unless a child has a diagnosed condition such as autism that has been scientifically proven to be helped by melatonin, there is no medical rationale for a child to be given it…Most paediatricians know little about sleep or melatonin. For non-autistic children it is a fashionable treatment for parents wanting ‘perfect’ children.
The Canadian Pediatric Society
In June 2013 the Canadian Pediatric Society published an interesting paper about the topic – here is a summary of some of their main points:
- Good sleep hygiene should always be implemented before melatonin is considered.
- There is no evidence supporting the use of melatonin for kids under the age of 2.
- Melatonin has been found to help improve sleep for some children. Namely with sleep disorders such as behavioral insomnia or delayed sleep phase type. Interestingly they state that most studies showing this involve children in special populations. Namely children with autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD).
- They then say the studies are very limited showing how effective melatonin is for kids. This is because there haven’t been many done, and there were only a small number of children in each study.
- They further state that there is a lack of research into the long-term effectiveness and safety of using melatonin.
The UK National Institute for Health and Care Excellence (NICE)
NICE state on their website that there is only one licensed melatonin product in the UK (Circadin, Flynn Pharma Ltd).
Circadin is a 2mg melatonin pill which is only licensed for adults over 55 years with primary insomnia. If doctors give it to children, it means it’s ‘off-label’ – which is what the Guardian reports as being on the rise.
However, NICE go on to state that there is ‘no high-quality evidence’ that melatonin helps children with sleep disorders and ADHD. In fact, only a small number of limited trials have shown it to be safe and effective for children with ADHD.
Interestingly, they do point out that it appeared to be generally safe in the clinical trials:
Unlicensed melatonin used in the RCTs was well tolerated in children during short-term (up to 4 weeks) and medium-term (average 18 months) use. Only mild transient adverse effects were reported throughout. The most common adverse events reported in the melatonin group of the larger 4-week RCT were headache (n=3; 5.7%), hyperactivity (n=3; 5.7%), dizziness (n=2; 3.8%) and abdominal pain (n=2; 3.8%)
What does it all mean?
It appears that even the medical world isn’t entirely in agreement. Some sources say it should be avoided altogether. Others say it’s reasonable in certain circumstances, such as for children with ADHD or autism.
There seems to be only one concept which is repeated throughout the medical world: there still hasn’t been enough research into the long-term safety.
Arguments against giving kids melatonin
People have many different thoughts about this, as you might imagine in such a controversial topic. Here are a few of the key reasons that so many people disagree with the idea:
1. Kids have a high amount of melatonin anyway
Children have a naturally high amount of melatonin in their body. It might be worth asking your child’s doctor to test them for melatonin deficiency first.
2. Isn’t it just wrong to give children a synthesized hormone?
This is a concept which comes up time and again in comments in news articles, blogs, and forums. This is a personal viewpoint which obviously depends somewhat on your leaning towards natural remedies.
3. The risk of side effects
Melatonin is known to have an extensive list of possible side effects come with it. You can read the article about melatonin overdose to find out more about these.
Some people talk about risks such as it affecting the development of the ovaries or testes in puberty. This hasn’t been researched properly, but the possibility does sometimes appear in medical sources.
4. Parents should control the bedtime routine instead
Perhaps parents can help their children with a more effective and consistent bedtime routine. This is another reason medical professionals recommend good sleep hygiene first.
5. Some children are just overactive, aren’t they?
This sounds a reasonable argument if a parent gives a child melatonin after just a few nights of not sleeping. But some children do have diagnosed sleep disorders which last months or years.
6. Isn’t it just plain wrong to drug your child?
Again this is another emotive point that many people make. Is it ethically right to ‘put your child to sleep’? When you phrase it in terms like ‘drug your child’ then it does sound bad. But the very idea of using melatonin to put a child to sleep night after night clearly worries some people.
7. Isn’t it making life easier for the parents?
I imagine there are some parents who might see it as a way to get more peace and quiet. But you have to hope that most parents are thinking more about their child’s well-being than their own.
So why do parents give melatonin to their kids?
This is a tricky question to answer because there are so many different factors which contribute to decisions like this. But there are some principle reasons parents might be in favor of using it:
1. A doctor recommends it
Some doctors do recommend melatonin for kids in certain situations. And some parents who are desperate for a solution to their child’s sleeplessness may naturally take the advice of a doctor.
2. Worried about the health effects of sleep deprivation
Sleep deprivation can cause a range of other health problems. So parents have to weigh up the pros and cons of the side effects of melatonin with the effects of missing so much sleep.
3. Concerned about problems with school
Sleep problems are also strongly linked with academic achievement, as well as overall well-being at school.
4. They don’t know what else to do
Not all parents have the knowledge or ability to control their child through extensive sleep hygiene and behavioral work.
5. They’ve tried everything else
Some parents will feel at a complete loss of how else to help their child sleep. The strain it puts on the family as a whole leads to them considering any option which might help.
As you can see, it’s not so easy to decide whether it’s right to give children melatonin. It may be that the very idea horrifies you. But if you’re reading this, you’re probably stuck somewhere in the middle or are at least curious.
In summary, I think there are a few key points to keep in mind:
- Even if you can get it over the counter or online, talk to a doctor first to get a professional and personalized opinion. They can tell you if it might work, how much to take, how long for, and what side effects you might expect.
- Try to help your child develop a stable sleep routine and habits first, particularly with regards to bedtime activities and schedules.
- Do more research into the possible side effects of melatonin.
- Get a thorough understanding of how melatonin works. It’s not the same as other sleeping pills and if you don’t know how it works, it may surprise you. It may also help you understand other ways you can help your child keep their body clock working well.
Please feel free to share your thoughts and opinions on this controversial subject below.