Kids need plenty of shut-eye to fuel their growth and development, but 15% to 25% of young people have trouble falling and staying asleep, according to the American Academy of Pediatrics (AAP). Lack of sleep has plenty of negative consequences, ranging from difficulty concentrating to obesity to crankiness. That’s why some parents are tempted to give their children a sleep supplement like melatonin during restless nights. But is melatonin safe for kids?
In September 2022, the American Academy of Sleep Medicine (AASM) released guidance saying parents should talk to a health care provider before giving melatonin to kids. That’s partly because melatonin doesn’t have Food and Drug Administration (FDA) oversight like other medications. “Melatonin content in supplements can vary widely. In one study, melatonin ranged from less than one-half to more than four times the amount stated on the label,” says the AASM report. “The most significant variability in melatonin content was in chewable tablets—the form children are most likely to use.”
What’s more, there’s been more melatonin overdoses among kids in recent years. A 2022 study from the Centers for Disease Control and Prevention (CDC) that reported a 530% increase in melatonin overdoses in kids between 2012 and 2021. It also announced 260,435 pediatric melatonin overdoses during the past decade (most were unintentional, occurred in the home, and were managed on-site). Additionally, there were 4,000 hospitalizations, 300 ICU cases (including five kids needing ventilation), and two deaths (one 3 months old and the other 1 year old) related to melatonin.
The truth is that low doses of melatonin can be safe for children, but researchers don't yet understand the long-term effects. The AASM suggests other methods to help your child sleep instead, such as a "change in schedules, habits, or behaviors."
If you use melatonin, it's important to follow appropriate dosing directions and store the supplement out of the reach of children—preferably in childproof cabinets or containers. It's also important to speak with a health care provider about dose and timing. Here, we answer some more common questions about melatonin in kids.
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How Does Melatonin Work?
Before you consider bedtime supplements for your kids, you should understand sleep cycles. Here's how they work: Our brain starts releasing melatonin—a hormone produced in the pineal gland—as it gets dark at night to help us fall asleep. In the morning, when we need to wake up, the melatonin mostly shuts off. Essentially, melatonin works by regulating your circadian rhythm, also known as your "internal clock."
Supplements contain a synthetic form of natural melatonin, and they usually make kids (and adults) tired within 30 minutes. They’re available over-the-counter as gummies, pills, liquids, or chewable tablets. Research shows that melatonin supplements can help autistic children, children who have attention-deficit/hyperactivity disorder (ADHD), and kids with other neurodevelopmental disorders fall asleep faster—and a few studies have shown similar effects in neurotypical kids.
Is Melatonin Bad for Kids?
Low doses of melatonin may be safe for children. That said, researchers still don't know the long-term side effects of taking any amount—even on an as-needed basis. "Melatonin is a drug and should be seen as that," says Judith Owens, M.D., director of the Sleep Center at Boston Children's Hospital. That's why the AASM recommends talking to your health care provider before giving the supplment to kids.
Giving too much melatonin, or giving it at the wrong time, could mess up your child’s sleep schedule. Dr. Owens also warns that the concentration of OTC melatonin in supplements can vary, and they may contain other chemicals, such as serotonin. One study found that some chewable tablets claiming to contain 1.5 milligrams of melatonin had as much as 9 milligrams. The AASM report also discusses results from another study: “Melatonin ranged from less than one-half to more than four times the amount stated on the label.”
Additionally, some children may experience side effects from taking melatonin, which can include headaches, nausea, sweating, dizziness, bed wetting, and drowsiness in the morning. It’s important to note that the FDA hasn’t approved the use of melatonin for kids, like they have with other over-the-counter or prescription medications.
Melatonin Dosage for Kids
Always talk to your child’s doctor before giving your child melatonin. They can help determine if the supplement is necessary, and they can also advise on dosage and timing. Most experts will recommend starting with a low dose—usually around 1 to 2 milligrams for kids ages 4 to 6 and 2 to 3 milligrams for ages 6 to 12. Melatonin should be used with other behavioral interventions and for as short a time as possible.
Because melatonin could mess up sleep schedules when taken at the wrong time, you shouldn't give it to kids in the middle of the night. Also, while the supplement can aid kids who have major difficulty falling asleep, it may not help any child stay asleep.
Always be careful to give the correct amount of melatonin because it’s possible to overdose. According to the CDC, overdose symptoms might involve the cardiovascular, gastrointestinal, or central nervous systems—but death is also possible in extreme cases. Store melatonin out of the reach of children to prevent accidents, preferably in childproof cabinets or containers.
How to Help Kids Sleep Without Melatonin
Before considering gummy, chewable, capsule, or liquid melatonin for kids, you might want to try other methods to help them sleep. If the issue persists, though, talk to your pediatrician about next steps.
Find the root cause of restlessness.
If your child is having trouble settling down, ask yourself why. Are they worried about something? Is their bedtime too early? Perhaps they have sleep apnea or restless legs? Pinpointing the cause can help you find an effective solution rather than a band-aid fix.
Go to bed at the same time each night.
While kids might fight against a set bedtime, having a predictable sleep schedule can help regulate their internal clock and can eventually make bedtime a much smoother evening affair for everyone.
Create a bedtime routine.
Help your child relax before bed with meditation, music, reading, or other soothing activities. “What the actual routines are can be specific to your child and [their] age, but they should occur each night around the same time,” says the AAP. “This will help your child understand that it’s time to settle down and get ready to sleep.”
Limit technology before bed.
Stop using screens at least an hour before bed. The light from screens uses blue light, which is made up of shorter wavelengths that are perceived by the brain as a cue to be alert and awake. Since blue light occurs naturally, the human brain uses it to help set internal clocks that tell us when we should be sleepy. Nighttime exposure to the blue light from electronics can trick the brain into thinking it’s time to be awake rather than asleep.
How Much Sleep Your Child Needs
When kids don't get enough sleep, they can be overtired, which can lead to some undesirable results including crankiness and reduced ability to focus. Ironically, overtiredness can also make falling asleep more difficult. By knowing how much sleep your child needs, you can help to ensure that they are well-rested.
According to the AAP, children need plenty of sleep, but how much depends on their age. Here is what they recommend:
- Infants 4 to 12 months need 12 to 16 hours of sleep, including naps.
- Toddlers 1 to 2 years old need 11 to 14 hours of sleep, including naps.
- Preschoolers 3 to 5 years old need 10 to 13 hours of sleep, including naps.
- Grade schoolers 6 to 12 years old need 9 to 12 hours of sleep.
- Teens 13 to 18 years old need 8 to 10 hours of sleep.
The Bottom Line
When taken with a doctor's approval, melatonin may help solve some children's sleep issues—especially if it's paired with other behavioral interventions. Still, the supplement shouldn't be used as a substitute for "good sleep habits, like maintaining a bedtime routine, especially if your child doesn't have a diagnosed sleep problem," says Dr. Owens.
