Do's and Don'ts of Giving Melatonin to Kids
You’ve done all the tucking, the snuggling, the water-fetching and have said goodnight to the moon at least a half-dozen times, but your little one is still up way too late. It’s bedtime battles like these that have led more and more parents to consider melatonin for a quick-and-easy fall-asleep solution for their kids. It may work for you—but is melatonin safe for your child?
Melatonin is a natural hormone in the body that helps regulate our body clock—also known as circadian rhythm. When the sun begins to set, our bodies increase production of melatonin to prepare us for sleep.
“Our bodies begin producing melatonin around two hours before our natural sleep time when the lights begin to dim,” explains Manisha Malik, MD, neurologist and sleep medicine specialist at Children's Healthcare of Atlanta. "Natural melatonin surges in the middle of the night and then begins to taper off.”
Melatonin supplements are lab-made, and they’re designed to mimic the effects of the natural hormone to hasten drowsiness. These supplements can be found in pill form, as a liquid, a chewable and even a gummy.
The short answer: yes. “Melatonin is typically very well-tolerated,” says Dr. Malik. Possible short-term side effects are mild and usually subside over time. These include:
- Gastrointestinal discomfort
However, there’s still a lot we don’t know about melatonin supplements, particularly the long-term effects, adds Dr. Malik. “Melatonin falls under the category of dietary supplement, so regulation by the U.S. Food and Drug Administration is not as stringent. It is regulated for safety, but it does not go through the rigorous approval process like medications do.” For parents, this means it’s important to educate yourself on when and how to use melatonin appropriately.
Melatonin should not be necessary for the average kid, says Dr. Malik. But there are some who might benefit from short-term use. This includes kids who experience insomnia or trouble falling asleep due to:
- Trauma or loss
- Extended illness or hospital stay
- Concussion or other injury
Dr. Malik also recommends melatonin for kids who have certain sleep disorders, such as:
Delayed sleep phase disorder (DSP)
If your child is a night owl, they may have DSP. This is a disorder common in adolescence in which a child cannot fall asleep at a “normal” time. Instead, they may stay up for hours after their recommended bedtime, which means they aren’t getting enough sleep, especially if they’re rising early for school. Melatonin can help kids reset their body clock and get back to a normal schedule.
Jet Lag Disorder
When your family travels across multiple time zones, you and your child may experience jet lag. This is a temporary sleep problem that can disrupt your body clock and cause some not-so-fun side effects like insomnia and fatigue, diarrhea or constipation, and irritability.
Other common sleep problems call for more than melatonin. Consider a discussion with your pediatrician or a referral to a sleep specialist if your child shows signs of:
It’s possible for kids and adults to get sleep apnea, which is characterized by interrupted breathing during sleep. Snoring is a telltale sign, but kids may also breathe through their mouths or talk while asleep, have morning headaches, irritability, difficulty concentrating or other behavioral problems that can mimic attention deficit disorder (ADD). This is why Dr. Malik says it’s important to check for sleep apnea first before confirming an ADD diagnosis.
Restless leg syndrome (RLS)
RLS causes an uncomfortable sensation in the legs that makes kids want to move them. Most often, this sensation comes along at bedtime, which means kids with RSL likely will not settle in for sleep quickly or easily.
Which children should not take melatonin?
If your child is under age 2, Dr. Malik says melatonin is not a good idea. “I don’t prescribe melatonin at this age because the brain is still developing and maturing,” she says. Others who may not be good candidates for melatonin are kids who have migraine with aura or an immune disorder like lupus.
For most kids, short-term use is best. “I would recommend no longer than two to three weeks in most cases,” says Dr. Malik. The exception is kids with diagnosed attention deficit disorder (ADD) or autism spectrum disorder (ASD). They may take melatonin for longer periods. According to Dr. Malik, studies have shown the benefits of melatonin and quality sleep far outweigh any theoretical risks for these kids.
Is it possible to overdose on melatonin?
It is possible for kids to have too much melatonin; however, overdose and serious side effects are very rare. Symptoms of an overdose might include lethargy, low blood pressure and disorientation. The right dosage for kids varies depending on your child’s age. Dr. Malik recommends:
- 1 to 3 mg for ages 3 to 5
- 2 to 5 mg for ages 5 to 10
- 5 to 10 mg for adolescents
“Always start at the lowest dosage and increase gradually,” she says. “The highest dose a child should have is 12 mg. Parents also need to be aware that, because these over-the-counter supplements are not strictly regulated, studies show the dosage shown on the label is not always accurate.” This is another good reason to start with a lower dosage and gauge your child’s response over time.
For most kids, the key to a good night’s sleep is not a sleep aid, but rather good sleep hygiene. Dr. Malik recommends these healthy habits for everyone in the family to help ensure quality sleep:
- Start winding down an hour or two before bedtime.
- Have a set bedtime and wake-up time each day (on weekends, this can shift by a couple of hours).
- Keep bedrooms dark, quiet, and cool (around 69 to 71 degrees).
- Limit exposure to electronics at bedtime.
- Follow a bedtime routine.
- Read books that are familiar and less stimulating.
- If kids must have electronics at bedtime, try an audio book, calming music or a video they’ve seen before.
- Avoid white or blue nightlights; use warm hues like orange, red or yellow instead.
- Try ambient noise to soothe, such as a fan or noise machine.
- Get outdoors during the day; light exposure during the day is necessary for natural melatonin production.
- Kids ages 5 and up should be getting 10 hours of consistent sleep daily.
How do I know if my child is getting enough sleep?
Most kids will go through periods of disturbed sleep or will have difficulty falling asleep at times. But if your child is consistently taking longer than 30 minutes each night to fall asleep, then talk to your doctor. “If they’re in bed and calm without your help, then there’s less reason to be concerned,” says Dr. Malik. “But it’s always a good idea to share your child’s sleep habits with their doctor.” Other signs to look out for that may indicate your child is getting low-quantity or low-quality sleep include:
- Your toddler regularly falls asleep in the stroller or car seat.
- Kids over 5 are requesting or taking naps during the day.
- Adolescents and teens are short-tempered and unable to stay on-task.
If your child is having trouble falling asleep or is showing signs of sleep deprivation, Dr. Malik advises reaching out to your doctor or a sleep specialist before trying melatonin.
This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on the Children’s Healthcare of Atlanta team are independent providers and are not our employees.