Researchers caution growing melatonin use among kids, while CRN contests findings

15 Nov 2023 --- Researchers caution that melatonin consumption by US children and adolescents is “exceedingly common,” while studies on the long-term use of the hormone in sleep supplements are lacking in this population. Through an online survey with parents, the researchers found that 18.5% of kids aged 5-9 and 19.4% of those aged 10-13 had used melatonin in the past 30 days.

The youngest age group examined (one to four years old) had the lowest use of melatonin in the past 30 days, at 5.6%. However, this is still higher than an earlier study, which found that 1.3% of US parents reported that their kids used melatonin during 2017-2018. 

“We hope the study draws attention to the substantial number of parents that are turning to melatonin to help with children’s sleep difficulties,” lead author Lauren Hartstein, a postdoctoral fellow at the University of Colorado, tells Nutrition Insight. 

“We also hope it encourages more research on behavioral sleep problems throughout childhood, as well as more conversations between parents and health care providers about concerns regarding children’s sleep.”

Meanwhile, the Council for Responsible Nutrition (CRN) counters that the research letter, published in JAMA Pediatrics, cites irrelevant and flawed data to “raise unnecessary alarm about pediatric use of melatonin.” 

The survey was completed by parents of 993 children aged one to 13.9 years, commenting on their kids’ sleep-related patterns, including melatonin use in the past 30 days. 

An online survey with parents found that 19.4% of those aged 10-13 had used melatonin in the past 30 days.Growing use for children 
The online survey also indicates that the dose and duration of melatonin use differ significantly across age groups. Kids aged 1-4 consumed a mean dose of 0.5 mg for an average of 12 months, while those aged 10-13 used a standard dose of 2 mg of melatonin for an average of 21 months. 

Hartstein emphasizes that from the data collected, the researchers cannot determine if the increase in melatonin use means children have more sleep problems. 

“Children’s sleep problems have always been a concern for parents, as each developmental stage has its changes and challenges for sleep. But these findings indicate that parents are searching for solutions, and melatonin is increasingly being marketed to parents as an easy and ‘natural’ option to help children sleep.”

While Hartstein asserts that melatonin is not necessarily harmful to children, further research is crucial, especially as the current survey is small and may not represent usage nationwide. 

“More research is needed on any effects of long-term melatonin use on development, specifically examining any changes in puberty or natural melatonin production.” 

Healthy sleeping habits 
Hartstein advises parents to consult a healthcare professional about any underlying factors contributing to sleep difficulties and behavioral changes that could be implemented before starting melatonin with their kids. 

“Additionally, giving children melatonin to fall asleep may result in an over-reliance on the supplement, teaching kids that medication is the answer at a time when they should be developing healthy sleep habits.” 

Co-author of the research letter, Julie Boergers, a psychologist and pediatric sleep specialist at Rhode Island Hospital and Brown University, highlights that melatonin can be a valuable short-term aid, particularly in youth with severe sleep problems. 

“But it is rarely a first-line treatment,” she underscores, noting that she often recommends families to use melatonin temporarily and first look at behavioral changes. “Although it’s typically well-tolerated, whenever we’re using any kind of medication or supplement in a young, developing body, we want to exercise caution.”

The researchers note that more studies are needed on long-term effects for kids using melatonin.Melatonin regulation 
As melatonin is regulated as a dietary supplement in the US by the Food and Drug Administration (FDA), Hartstein notes it “faces much looser regulation.”

“A recent study found that the melatonin content in many over-the-counter supplements can vary substantially from what it says on the label.” 

This research, published in April, reported that across 25 melatonin gummy products, 22 contained different amounts than the label indicated. The melatonin quantity ranged from 74% to 347% of the labeled content. 

Moreover, the US Centers for Disease Control (CDC) warned last year that unintentional melatonin ingestion in children under five has risen, indicating a growing consumption of the sleep supplement. 

CRN criticism 
Commenting on the research letter’s findings, CRN urges that the study merely underscores the popularity of safe products. Moreover, the letter claims that melatonin “is not regulated by the FDA” in the US as a dietary supplement, which the CRN emphasizes is untrue. 

“This Research Letter should be received as a call to pediatric doctors to have candid and open conversations with parents about their children’s sleep patterns and about the use of melatonin, which these findings, and our data, show is used safely by millions of American families,” says Steve Mister, president and CEO at CRN. 

“What this study doesn’t show is how many families already administer melatonin to their children safely, in consultation with, and in many cases, at the suggestion of, their healthcare providers. Misrepresenting the state of regulation and mischaracterizing the data to pediatric doctors make those candid and fact-based conversations less likely.”

The council also notes that earlier studies cited in the research letter are flawed. The study raising concerns about melatonin levels in products did not acknowledge that federal regulations allow reasonable overages and that actual ingredient levels were safe. A cited research on the increase in calls to CDC poison control centers on melatonin ingestion did not relate to harmful overdoses.

By Jolanda van Hal