Experts advise against giving your restless child melatonin over poisoning fears

Parents are being warned against giving children melatonin following a surge in accidental poisonings.

Experts said there is no evidence the over-the-counter supplement helps them get to sleep and they have no idea what is actually in many products. 

Our bodies naturally produce the hormone melatonin to fall asleep by helping to regulate the circadian clocks that control our sleep/wake cycles. 

Melatonin supplements may improve your sleep if you have disrupted circadian rhythms due to certain life circumstances such as jet lag or working the night shift. 

But they should never be the first tool parents of restless children reach for, according to sleep scientists.   

Increasingly, the supplement is being sold in gummy or chewable form with appealing flavors such as fruit punch, a feature that experts warn make them enticing to children. 

‘The availability of melatonin as gummies or chewable tablets makes it more tempting to give to children and more likely for them to overdose,’ said Dr M. Adeel Rishi, vice chair of the American Academy of Sleep Medicine. 

But evidence that the sleep aid can help children with insomnia is scant and experts advise parents to work closely with a pediatrician before giving it to a child. 

Pediatric melatonin ingestions reported to poison control across the US between 2012-2021

A store shelf of melatonin supplements formulated for children

A store shelf of melatonin supplements formulated for children

Olly kids melatonin gummies

Children's melatonin berry gummies

Olly kids melatonin gummies

What is melatonin and how does it work? 

– Melatonin is one of the most widely used sleep aids in the US

– It’s a hormone that your body produces naturally in response to changes in daylight 

– Melatonin levels rise in the evening and promote sleep

– With a pediatrician’s guidance, it can be safe for children

– Melatonin content can vary widely by product so parents are urged to use caution 

– It should only be used if other methods such as limiting screen time and setting an earlier bedtime fail 

 ‘Parents should talk directly with their child’s health care professional before giving their children melatonin products,’ Dr Rishi added. ‘Often, behavioral interventions other than medication are successful in addressing insomnia in children.’ 

While it can help insomniacs fall asleep faster and stay asleep, experts caution that less is more. Take 1 to 3 milligrams two hours before bedtime, according to Johns Hopkins sleep expert Dr Luis F. Buenaver.

It has become the go-to prescription-free tablet for people struggling to sleep and the market is booming. Sales increased from $285 million in 2016 to $821 million in 2020, according to federal reporting.  

The supplement is also ubiquitous. A 30-pill bottle can be purchased at nearly every pharmacy for as little as $10 (£9.10). 

The AASM’s warning comes on the heels of a report from the Centers for Disease Control and Prevention (CDC) published in June that said annual pediatric ingestions of melatonin increased 530 per cent from 2012 to 2021 with a total of 260,435 ingestions reported.  

Melatonin ingestion accounted for nearly 5 per cent of all pediatric poisoning cases in 2021 compared with 0.6 per cent in 2012, and was the most frequently ingested substance among children reported to national poison control centers.

Melatonin sales have exploded, particularly during the Covid pandemic

Melatonin sales have exploded, particularly during the Covid pandemic

Demographic breakdown of poison control reports.

Demographic breakdown of poison control reports.

Gummies in fruity flavors appeal to children, as do celebrity endorsements.

Gummies in fruity flavors appeal to children, as do celebrity endorsements. 

Melatonin gummies

Melatonin gummies

Hospitalizations due to melatonin ingestions also jumped in that period particularly in children five and younger, with five children requiring mechanical ventilation and two died. But only 1 per cent of children needed intensive care. 

While the vast majority of cases reported to poison control were asymptomatic, around 84 per cent, more severe symptoms involved the gastrointestinal, cardiovascular, or central nervous systems. 

Melatonin overdose is rarely deadly, but more severe cases can cause very low blood pressure, disorientation, and tremors. Vomiting is a common side effect of melatonin poison, and when your child begins slurring their speech, it’s time to go to the emergency department.    

Melatonin content can vary widely, with the greatest variation in gummy formulations more likely to be used by children. 

‘In addition, serotonin, a breakdown product of melatonin, was found in 26 per cent of supplements at potentially clinically significant doses that can increase the risk for serotonin toxicity in children,’ the CDC reported.   

Dietary supplements such as melatonin and multivitamins are not subject to the same stringent regulatory barriers as prescription drugs and biologics. 

The safety of melatonin is guaranteed by the Food and Drug Administration only so far as to prove that the product is unsafe in the event that it proves to be harming people and then take legal action against the manufacturer. 

‘Instead of turning to melatonin, parents should work on encouraging their children to develop good sleep habits, like setting a regular bedtime and wake time, having a bedtime routine, and limiting screen time as bedtime approaches,’ Dr Rishi said.