Can Too Much Melatonin Be Dangerous for Children? This Study Says Yes

A June 2022 study from the Centers for Disease Control and Prevention (CDC) shows that between 2012 and 2021, there was a 530% increase in melatonin overdoses in kids. Within those dates, there was a spike of 37% between 2019 and 2021, which appears to overlap with the pandemic.

In the past decade, there have been 260,000 cases of suspected overdose of melatonin reported to Poison Control across the U.S., which includes more than 4,000 hospitalizations, 300 ICU cases, five cases where kids required ventilation, and two children ages three months and one year died.

Parents often turn to melatonin because it's marketed as a natural and safe way to help kids get the sleep they need, but reality is more complicated. The American Academy of Sleep Medicine (AASM) released a September 2022 report advising parents to consult their health care provider before giving melatonin to their kids. Their reason, in addition to the increase in overdoses, is that the supplement is unregulated by the FDA, and melatonin content in supplements can vary widely.

If given the green light from their doctors, parents must follow appropriate dosing directions and properly store melatonin away from their kids' reach. But other sleep strategies—such as a "change in schedules, habits, or behaviors"—should first be considered instead, says the AASM.

What Is Melatonin, and What Does It Do?

Melatonin is a naturally produced hormone that occurs in response to darkness. Basically, when the sun sets, our bodies signal that it's time to rest by producing a sleep hormone called melatonin. Scientists think that melatonin may play an important role in other areas of our health; however, little is known about this hormone, and more studies need to be done.

When a person has trouble sleeping, it's commonly believed that a melatonin supplement can help that person fall asleep naturally and safely. Many people take melatonin with no problems, and many parents administer the drug to their children with no side effects. But that doesn't mean melatonin is 100% safe.

Read more on what experts say about melatonin, how it works, and if it is safe for kids here: Is Melatonin Safe for Kids?

Melatonin Is Still Not Fully Understood

The study from the CDC makes clear that melatonin is still not a fully understood drug. We may think of it as a harmless, all-natural supplement; after all, our bodies naturally produce it, so what could be the harm? But that's just not the reality. Despite that, sales of the popular sleep supplement went from $285 million in 2016 to $821 million in 2020, making this particular drug incredibly popular.

According to the National Center for Complementary and Integrative Health (NCCIH), melatonin is regulated by the Food and Drug Administration (FDA) as a dietary supplement. While that may sound assuring, it means that melatonin is not regulated as strictly as a prescription or over-the-counter drugs. What's more, the melatonin you purchase may not even contain what is listed on the package.

For example, the NCCHI says that a 2017 study tested 31 different packages of melatonin from different sources like a grocery store or pharmacy and found that what was listed on the packages did not match what they found in the drugs themselves. As many as 26% of those tested had serotonin in them, which can be dangerous to take even at minimal levels.

Proper Storage is Needed to Keep Kids Safe

The CDC study clearly shows that rates of melatonin use are skyrocketing in recent years, and along with that are increased rates of overdosing and possibly even long-term adverse side effects in very young kids.

The study showed that teenagers were more likely to have intentionally taken too much melatonin. This could be connected to increases in stress and anxiety in teens during the pandemic, which could be impacting their sleep patterns. Parents should have conversations with their teenagers about safe medicine use and bring up any concerning sleep patterns to their doctors.

The CDC also pointed to accidental overdoses for kids under the age of 5 that led to hospitalizations. Experts think this may be due to a lack of regulation on how melatonin gets packaged. Parents should make sure that the melatonin they are purchasing comes in childproof packaging. Even though it's branded as a natural sleep aid, melatonin should be treated like a medicine. It should be kept out of reach from children in a medicine cabinet or locked closet, like all other medications.

What Does a Melatonin Overdose Look Like?

An overdose of melatonin is serious and requires immediate medical attention. Parents who administer melatonin to their children should look out for the following symptoms:

• Sweating
• Increased heart rate
• Agitation or irritability
• Restlessness
• Anxiety
• Upset stomach

These side effects are often due to high levels of serotonin present, either in the supplement itself or from the body's processing of it, says Benjamin U. Nwosu, M.D. chief of endocrinology at Cohen Children's Medical Center in Queens, New York.

"The side effects of melatonin are not completely known yet. When a person takes melatonin, it is converted into other products in the body such as serotonin," says Dr. Nwosu. "It doesn't matter how small the dose is; what matters is that we don't know how the body processes the by-products of melatonin."

Dr. Nwosu adds that the best recipe to fix sleep problems is not a pill but healthier sleep hygiene. Getting back to sleep basics and making sure that kids (and parents) schedule sleep, avoid screens before bedtime, avoid eating or playing in bed, and create a reliable routine is the best medicine.

But if parents feel that melatonin is a supplement that they truly need, they should speak with their health care provider before giving it to kids. Dr. Nwosu also offers some sound advice. "If you limit [melatonin] to the lowest dose possible, then you may escape the side effects," he says. Dr. Nwosu encourages parents to educate themselves about the potential side effects of melatonin, minimize the dose given to children, ween them off melatonin as soon as possible, and develop a healthy sleep hygiene plan for the whole family.

The Bottom Line

Melatonin is a hugely popular, easily accessible sleep aid supplement, but it may not always be safe to use. Always talk to your health care provider before giving melatonin to kids. It's important that parents properly store all medication, including sleep aids, in a location not accessible to children. More studies need to be done on how the body processes melatonin, and more needs to be done to regulate melatonin to ensure safety.