If you’ve never heard of melatonin for kids, then you probably aren’t someone who searches the internet for solutions to your kid’s sleep problems.
Barely talked about among parents even just a decade ago, melatonin is quickly becoming a go-to sleep solution for kids. “It’s easily accessible, and is being promoted as a sleep aid,” says Burlington, Ont.-based sleep consultant Alanna McGinn. Health Canada classifies melatonin as a natural health product, which means you can buy it at the pharmacy or a health food store, without a prescription. You’ll find it in the same spot you pick up your vitamin D or iron supplements.
With moms in Facebook groups championing the benefits and many paediatricians giving it the A-OK, you’re bound to wonder if it might just be that miracle fix you’ve been hoping for when it comes to your kid’s sleep. Here’s what you should know.
Melatonin is a hormone naturally released by our brains to help us fall asleep. Melatonin supplements can be helpful when that release doesn’t happen at the desired time—jet lag is an obvious example.
Carl Cummings, a paediatrician in Montreal who wrote a paper for the Canadian Paediatric Society entitled “Melatonin for the management of sleep disorders in children and adolescents,” explains that melatonin could be helpful in kids who have chronic insomnia because of a problem with "sleep initiation," which means the child is going to bed at an appropriate time, but it is taking longer than 30 minutes for him to fall asleep. Often, this issue can be solved with good bedtime routines and parents consistently setting appropriate limits around sleep. But in some cases, these strategies won’t work, which is where melatonin comes in.
What makes melatonin so compelling is that it will help most kids fall asleep. The problem is, it won’t help a kid who is procrastinating bedtime learn good sleep habits; it won't stop your daughter from waking up with nightmares; it won’t fix your baby’s colic; and it probably won’t stop your kid from hopping out of bed ready to start the day at 4:30 a.m. If you want a real solution to those common kids' sleep problems, you’ll have to look further than a pill.
In her sleep consulting practice, McGinn has met babies who have been on melatonin from as young as four months of age. (Melatonin comes in a number of forms, including liquids, gummies, chewables, capsules and tablets, and a number of dosages.) But, of the more than 500 melatonin-containing products licensed for sale in Canada, only two are licensed for teenagers (kids 12 and over), and there aren’t any approved for kids under 12.
Cummings, who does recommend melatonin to some of his pediatric patients as a treatment for managing insomnia, says the average kid under five would not have developed the type of sleep disorder where melatonin could be useful, and therefore they wouldn’t need it.
Kids with attention disorders and autism commonly develop sleep problems that can be helped with melatonin. Additionally, medication used to treat ADHD can lead to difficulty falling asleep. That was the case for Jackie Botman,* whose son has ADHD. The eight-year-old’s medication was keeping him up until 9:30 or later—he was wired and couldn’t settle down. “He was resistant to calming down and having quiet time. He became chronically tired,” says Botman, who lives in Toronto. Now her son takes a 5 mg dose of melatonin when he’s brushing his teeth, then gets into bed and falls asleep in a reasonable amount of time.
Although Cummings agrees that melatonin can help kids with ADHD or autism, he says the downside is that there’s a high relapse rate: Once you take your kid off melatonin, they are almost guaranteed to go back to having difficulty sleeping. “It sets up a situation where those kids, to function well in life and in school, may need to use the melatonin on a longer-term basis,” says Cummings.
Because melatonin is a hormone, there are concerns about how taking it might affect a child's growth and development, particularly during puberty. “When you look through the literature, all of the feedback that you get is very positive. It seems to be safe,” says Cummings. “The problem is, if you look at the number of studies and the number of subjects in the studies, they are actually quite small numbers. So it’s reassuring, but only to a point.”
Because melatonin is licensed as a natural health product, companies are not subject to the same manufacturing scrutiny when making melatonin supplements as they are when producing pharmaceuticals. That means you don’t have any reassurance that the package of 3 mg melatonin pills you picked up actually contains 3 mg doses. A study published in the Journal of Clinical Sleep Medicine in January looked at 31 products and found that 71 percent of them actually contained doses that were more than 10 percent off what was stated, and 26 percent contained unlabelled serotonin, which is not authorized for sale as a supplement.
Melatonin is released by our pineal glands in response to darkness as a part of our circadian rhythm. There are things you can do to help your kid’s sleep cycle get on track so that natural melatonin gets released at bedtime. Having a dark sleep environment, a consistent bedtime and limiting screens and snacks before bed all naturally promote melatonin and bring on sleep, says McGinn.
These types of sleep practices are called sleep hygiene—and Cummings says he would never recommend melatonin as a replacement for these practices. “We are in an age where families are often looking for a quick fix,” he says. “But not everything needs a pill to get better.”
*Names have been changed