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In the United States, nearly one in five children now take melatonin to sleep, and some parents regularly give this hormone to their healthy children. Experts warn of the potential dangers of such a practice.
American scientists warn of the too frequent consumption of melatonin by children while the safety and effectiveness data concerning these products are currently insufficient
Melatonin for children: a product that has become too common
Melatonin is produced naturally in the pineal gland to signal the body that it is time to sleep. It allows you to regulate your circadian rhythm, the physiological cycle over a period of 24 hours. In many countries, the hormone is classified as a drug and available only by prescription. In France, it strangely has the status of a food supplement if the product contains less than 2 mg and becomes a medicine beyond that with all the reservations and precautions specific to these products.
In the United States, the regulatory situation is quite similar: melatonin synthesized chemically or of animal origin is available over the counter as a dietary supplement, and increasingly available in the form of gummies suitable for children. This pushed the authors to focus on the distribution of this hormone in children.
“All of a sudden, in 2022, we started noticing that many parents were telling us that their healthy child was taking melatonin regularly” said Lauren Hartstein of CU Boulder’s Sleep and Development Lab.
In 2017-2018, only about 1.3% of U.S. parents reported that their children used melatonin. To get a sense of the current prevalence of use, Hartstein and colleagues surveyed about 1,000 parents during the first half of 2023.
The older the child, the higher the dose
According to the results of this study, it appears that among children aged 5 to 9 years, 18.5% had received melatonin in the previous 30 days. For preteens ages 10 to 13, that figure rose to 19.4 percent. Nearly 6% of preschoolers ages 1 to 4 had used melatonin in the past month.
Preschoolers who used melatonin had been taking it for an average of one year. Elementary school students and preteens used it for average durations of 18 and 21 months, respectively.
The older the child, the higher the dose, with preschoolers taking between 0.25 and 2 mg and preteens up to 10 mg.
More than 530% of ingestions reported to Poison Control Centers in 9 years!
In a study published in April, researchers analyzed 25 melatonin gummy products and found that 22 of them contained different amounts of melatonin than stated on the label. One of them had more than three times the amount indicated on the label while others contained none at all. Additionally, some melatonin supplements contain other substances of concern, such as serotonin. “Parents may not actually know what they are giving their children when they give these supplements,” Dr. Hartstein said.
Some scientists have also expressed concerns that giving melatonin to young people whose brains and bodies are still developing could influence the timing of the onset of puberty.
The few small-scale human studies that have looked at this topic have yielded inconsistent results. Gummies, in particular, also carry another risk: They look and taste like candy.
From 2012 to 2021, the authors note, reports of melatonin ingestion at poison centers increased by 530% , occurring largely in children under 5 years of age. More than 94% were unintentional and 85% were asymptomatic.
A medicine to be used by a healthcare professional
Co-author Julie Boergers, a psychologist and pediatric sleep specialist at Rhode Island Hospital and Brown University Alpert School of Medicine, said that when used under professional supervision health, melatonin can be a useful short-term aid. particularly in young people with autism or serious sleep problems.
Introducing melatonin early in life could also have another unintended consequence, Hartstein said: It could send the message that, if you’re having trouble sleeping, a pill is the solution.
An opinion shared by Dr Yves Dour, pharmacist and member of the Doctissimo expert committee last September:
“Certainly, the side effects – neurological, digestive or cardio-respiratory – can be dramatic in children. But in reality, from what I see in my pharmacy, melatonin is used very little in children. It is in fact prescribed by prescription and requires a medical diagnosis.“, specifies the pharmacist. “Unlike the United States, where melatonin is more easily mobilized, we cannot find this molecule over the counter beyond 1.9 mg (from 2 mg it is a medication and not a supplement food, editor’s note)”.
Favor other solutions to help children sleep
“If so many children are taking melatonin, it suggests that there are many underlying sleep problems that need to be addressed“Hartstein said.”Addressing the symptom does not necessarily address the cause“.
Thus, Dr. Dour also wanted to point out that many sleep disorders in children can be resolved by changing schedules and habits rather than by taking melatonin.
“We have to go back to basics. Before going to bed, it is necessary to promote relaxation, why not around reading, some quiet time… while avoiding stimulants such as screens and/or violent programs. Putting the child to sleep in good conditions is essential“, he concludes.
Recommendations similar to those of the American Academy of Sleep Medicine:
- Maintain a consistent sleep schedule. Help your child go to bed at night and wake up in the morning at the same time every day, even on weekends.
- Limit screen time before bed. Reducing screen exposure helps your body prepare for sleep. Encourage your child to unplug all devices at least 30 minutes to an hour before bed.
- Develop a relaxing nighttime routine. Encourage your child to adopt a nighttime routine that helps them relax and prepare for sleep. This may include a hot bath or shower, a newspaper, or reading before bed.
In conclusion, Dr. Hartstein states “We are not saying that melatonin is necessarily harmful to children. But there is still much research to be done before we can say with certainty that long-term treatment is safe for children.“.