Should parents use melatonin to help a child sleep?
The use of melatonin to help put children to sleep has jumped in recent years. In just 5 years from 2007 to 2012, sales of the drug jumped from $90 million to $260 million, and a lot of this rise is due to parents using the drug. (Galewitz, 2008) One melatonin manufacturer’s website even urges parents to “prepare your child for academic success” by using this product to help put him or her to sleep, then goes on to cite a study in which children who got less sleep had worse grades.
Doctors and pediatricians, however, aren’t so keen on this trend. So there are a few things you should know before drugging up your child to put them to bed.
What is melatonin?
Melatonin is a hormone produced by the pineal gland in the brain, which helps regulate the body’s sleep-wake cycle. Melatonin supplements are typically available over the counter without a prescription, and some are even specifically marketed for children.
Melatonin is a natural supplement, given unnaturally
Many parents think that because melatonin is a ‘natural’ hormone that it’s perfectly safe to use and doesn’t come with any side effects. This is a rather flawed way of looking at it. Just because your body produces something naturally doesn’t mean that adding a synthetic version artificially is without consequence. After all, even cocaine produces its high by flooding the brain with dopamine that your body produces naturally, but this doesn’t mean that cocaine is harmless.
The problem with any drug, whether you consider it natural or not, is that it alters the body’s chemistry. When you repeatedly alter the body’s chemistry like this, your body adjusts what it produces on its own, a process referred to as habituation. So if a parent continues to give their child melatonin supplements, it can alter a child’s ability to produce melatonin on their own, making sleep problems firmly entrenched in their physiology.
Health experts say that melatonin is “safe” in that it hasn’t been found to cause any serious side effects. This is hardly an endorsement for its widespread use. Almost no research has been done on the use of melatonin in children, and that which has is focused almost exclusively on special needs children. Little is known about its use in normal children, and the lack of evidence of serious side effects does not take away the habituation problem. There are also concerns about how the hormone supplement interacts with other hormones in the body, which could potentially affect things like fertility or sexual development.
The Overuse of Melatonin In Children
Although melatonin may be useful and affective in certain circumstances, too many parents are using it as a crutch. “Parents are using melatonin because they are stressed out,” says Michael Breus, a clinical psychologist and board-certified sleep specialist. “They come home late, eat dinner late, and they think they can just flick an on-off switch for their children to get to sleep.” He adds that he knows of parents who give their children melatonin for stretches of years at a time. (Breheny-Wallace, 2013)
“I’ve never seen such widespread abuse of any drug or therapy in all my years of practice,” says Stuart Ditchek, a clinical assistant professor of pediatrics at New York University School of Medicine. He describes one mother who “lines up her six healthy children nightly to give them their melatonin pill.” (ibid)
When should you give a child melatonin? Some guidelines for parents:
Melatonin is generally not recommended for children under 10, and you should always consult a doctor first before giving it to your child. If you do administer this hormone, it should be for the short term, unless your child has a diagnosed disability or other condition that might require a regular supplement.
“This is not a treatment for the healthy child with occasional trouble falling asleep,” says Marcia Buck, a clinical pharmacy specialist at the University of Virginia Children’s Hospital in Charlottesville. (Galewitz, 2008) It should always be used as a last resort and only after parents have tried other techniques of getting their child to sleep.
“Melatonin is very useful for some teens that cannot get to sleep,” so long as it’s used occasionally, says Susan Zaforlotfi, clinical director of the Institue for sleep-wake disorders at Hackensack University Medical Center in New Jersey. (Galewitc, 2008) Studies have found it generally safe if used for days or weeks. A dose given to children should not exceed 3 milligrams, and again, should not be given to kids under 10.
Parents should also consider the broader message that melatonin use sends. “For thousands of years our children have been falling asleep without the need for pills,” says Dr. Ditchek. “Giving your healthy child a pill to fall asleep is sending him the wrong message – that he needs a pill to do what should come naturally.” (Breheny-Wallace, 2013) This message could translate into all sorts of substance abuse problems later.