The Controversy Surrounding the Use of Melatonin in Children

The use of melatonin supplements in children, including preschoolers, is on the rise in the United States, despite the lack of sufficient evidence supporting its safety and effectiveness. According to a recent survey, almost one in five school-aged children and pre-teens are given melatonin to aid with sleep, a significant increase from the reported usage of 1.3 percent in a broader age group just five years ago.

While researchers are cautious about definitively stating that melatonin is harmful to children, they emphasize the necessity of conducting more extensive research to determine the long-term safety of its use in kids. Lauren Hartstein, a sleep and development scientist at the University of Colorado Boulder, highlights the importance of obtaining conclusive evidence before confidently asserting the safety and efficacy of melatonin supplementation in children.

A study conducted earlier this year interviewed parents of 993 children aged 1 to 13 about their kids’ melatonin consumption over the past month. The findings unveiled a significant shift in usage patterns when compared to data collected between 2017 and 2018, which included individuals aged 19 and under. The survey revealed that 5.6 percent of children aged 1 to 4, 18.5 percent of 5 to 9-year-olds, and 19.4 percent of 10 to 13-year-olds had taken melatonin supplements within the past month. Notably, children under 5 were given doses of up to 2 mg, while older children were administered doses of up to 10 mg. Long-term melatonin use for durations exceeding 12 months was also prevalent among children.

Unlike in other parts of the world where melatonin is regulated and requires a prescription, in the United States, it is classified as a dietary supplement by the FDA. Consequently, melatonin faces looser regulation and does not necessitate a prescription for purchase, contributing to its widespread availability and usage.

Melatonin is a hormone secreted by the pineal gland in our brain, signaling our bodies to wind down and prepare for sleep. It helps regulate our circadian rhythms, making it particularly attractive to individuals struggling with sleep difficulties. Existing evidence suggests that melatonin supplementation is safe for short-term use, typically one to three months, and in doses ranging from 0.5 to 1 milligram. However, the long-term effects remain unknown, raising concerns regarding its sustained use.

The increased prevalence of melatonin ingestion among children is not without its risks. The number of pediatric cases of melatonin ingestion reported to poison control centers has risen by a staggering 530 percent between 2012 and 2021, with a significant proportion involving children under the age of 5. Furthermore, a recent study analyzing 25 melatonin gummies available in the US market identified misreported melatonin content in 22 of the products. Notably, one of the gummies had a melatonin dose more than three times the amount indicated on its label. These inaccuracies raise concerns regarding parents’ limited awareness of the actual dosage they are administering to their children when using melatonin supplements.

While some evidence suggests that melatonin supplementation may benefit individuals with autism spectrum disorder in terms of improving sleep quality, its effectiveness, dosage, and long-term safety remain ambiguous in other populations. The authors of the research assert that these factors may vary according to age and emphasize the necessity of proper diagnosis and treatment for potential underlying sleep disturbances, rather than relying solely on melatonin as a symptom-based solution.

A Call for Addressing Sleep Issues at the Root

The high rates of melatonin use among children reflect a pressing concern regarding underlying sleep issues that need to be thoroughly evaluated and addressed. Rather than solely focusing on alleviating symptoms with melatonin supplementation, the authors stress the importance of identifying and treating the root causes of sleep disruptions in children. By addressing the underlying problems contributing to poor sleep, healthcare professionals can provide more effective and sustainable solutions for children experiencing sleep difficulties.

The increasing use of melatonin supplements in children, including preschoolers, raises significant concerns regarding safety, efficacy, and accurate dosage. While melatonin may aid sleep in certain populations, further research is necessary to determine its long-term effects and suitability for children. Healthcare professionals and parents alike should approach the use of melatonin with caution and consider comprehensive evaluations of children’s sleep patterns to ensure appropriate and evidence-based interventions.


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