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by Agustina Fernandez March 28, 2023 8 min read
Sleep is undoubtedly one of the most challenging aspects of infanthood. For the first few months, you’ll almost certainly be saying farewell to a good night’s sleep as it will be interrupted by cries, episodes of nighttime wakefulness, sleep regressions, and the like.
But before you give up in defeat of a seemingly endless sleep saga, know that your baby’s sleep patterns will become more regular with time! Until then, when your little one is sleeplessly squirming, what can you do?
Considering how prevalent melatonin use is as a natural sleep aid for adults, many parents find themselves considering whether this sleep hormone could help solve their baby’s sleep struggles.
In this article, we’ll discuss the safety of melatonin use for children and other tips to help your baby sleep better including what melatonin is and how it works, when it's appropriate to introduce melatonin supplements to your child, and some simple tips for good sleep hygiene.
Table of contents
Melatonin is a hormone with antioxidant properties. It is primarily produced in the brain by the pineal gland and in smaller amounts by other bodily organs. Its main function is to regulate our sleep and wake cycles. Melatonin treatment is used by adults for insomnia and for some children with sleep disorders.
You may have heard reference to the body’s biological clock. This internal clock or circadian rhythm coordinates our sleep as well as a wide range of other natural processes. It's governed by an area of the brain called the suprachiasmatic nucleus or SCN for short, found in the hypothalamus. The SCN stimulates the pineal gland to secrete melatonin based on physiological rhythms that respond to the 24-hour light-dark cycle of the natural or artificial environment.
You can think of melatonin as a timer that modifies our internal clock based on the time of day. The light that enters our eyes stimulates the brain cells that connect our retina to our brain; then, our brain's pineal gland (a brain area involved in melatonin production and secretion) responds to this information by inhibiting the release of melatonin during daylight hours to keep up more alert and awake. However, at night time, our melatonin levels rise to get us drowsy and ready for bed.
In addition to regulating our sleep-wake cycles, melatonin also has beneficial effects on many organs and tissues in the body including producing antioxidant and anti-inflammatory properties as well as other protective functions like reducing bone breakdown.
Synthetic melatonin products are available for people who suffer from sleep problems or don't produce enough melatonin in their bodies naturally.
At 3 months, a baby's pineal gland begins melatonin production. But before 3 months, babies obtain melatonin through breast milk. At this time, there is no variation in the amount of melatonin found in the blood between day and night, which suggests that an infant's circadian rhythm only develops after 3 months. During pregnancy, melatonin crosses the placenta, syncing the babies’ circadian rhythm to the mother’s.
A biological cause of insomnia is unlikely in infants that exhibit normal growth and development, in which case behavioral causes like feeding should be assessed as a first line of defense. For example, gastroesophageal reflux (GORD) is a common cause of interrupted sleep in infants.
The use of melatonin for babies is seldom recommended. In rare cases, however, the use of melatonin for babies who suffer from pediatric insomnia is recommended. This is characterized by repeated difficulty with initiating sleep or staying asleep and may be related to the lack of sleep consolidation that occurs despite a baby's age or developmental stage. Disrupted infant sleep can lead to functional impairments during the day that affect both the child and the family.
In toddlers, sleep disturbances need to first be assessed by evaluating external factors such as meal times, screen time, and sleep time. Commonly, problems within the family and a child’s fears are associated with sleep disturbances, and interventions like parental education and appropriate bedtime routines are should be used before considering melatonin use in children.
Largely, behavioral causes of insomnia are resolved through proper sleep hygiene. So to help ease your little one's sleep in the right direction, check out our list of the top 6 steps you can take to improve your child's sleep hygiene.
Avoid daytime naps ☀️
Have dinner at least 2 hours prior to bedtime 🍽️
No screen time for at least 1 hour before bedtime 📱
Maintain a regular bedtime and wakeup routine ⏰
Ensure your child sleeps in their own bed 🛌
Maintain a cool, dark, and quiet sleep environment 🌚
Melatonin use appears to be generally safe and effective for children with difficulties falling or staying asleep in the short term. Long-term use of melatonin in children is only appropriate for those suffering from sleep issues related to developmental challenges and visual impairment.
It is important to remember that melatonin supplements are a drug and before considering their use, the cause of sleep problems should be identified. As we mentioned already, for most children, behavioral changes work well enough to address sleep difficulties without the need for medical intervention.
Synthetic melatonin supplements are an alternative sleep aid that many prefer over potentially habit-forming sedative medications. It's economical and widely available without a prescription and can be found in various forms including liquid, capsule, gummies, and melatonin drops for babies.
Pediatric melatonin ingestions are becoming more widespread due to how available melatonin is to purchase, and toddlers are at increased risk of melatonin poisoning because it is so easily accessible. Parents should take precautions to ensure that all medications including dietary supplements are safely stored and out of reach.
Melatonin has anti-inflammatory and antioxidant properties, which contribute to its potential benefits. It's also an effective free radical scavenger. It's been utilized to treat disorders such as respiratory distress syndrome, bronchopulmonary dysplasia, and sepsis and has neuroprotective benefits, particularly for newborns!
Despite these benefits, the medical use of melatonin for newborns is rarely recommended for sleep problems that are typically a result of unrelated causes like acid reflux (GERD).
Learn More: Why Do babies Spit Up Breast Milk and Formula?
It is therefore advised that you speak with your pediatrician to determine the cause of your infant’s sleep troubles before considering newborn melatonin supplementation.
In some cases, taking melatonin supplements is useful in instances outside of medical intervention such as when dealing with insomnia due to jet lag or shift work. Did you know that about 25% of preschool and school-aged children suffer from sleep disorders?
Melatonin has been used in children with sleep disorders and in those suffering from seizures. Some studies have found melatonin safe and beneficial for children on the autism spectrum mainly as an aid to their frequently interrupted sleep.
Again, while melatonin shows remarkable benefits for these medical complications, it is not advised to reach for it without a doctor’s assessment.
There is general agreement that melatonin therapy is safe at appropriate doses, but high pharmacological doses should be used with caution and under medical supervision. There has been no evidence of severe complications with long-term melatonin therapy in adults or children.
In children, it is typically administered in doses of 1.5 – 3mg and 5 -10mg in adolescents about 30 – 60 minutes before bedtime.
So if you're looking for an alternative to melatonin for infants, here are some simple things you can do to support your child’s sleep:
Manage the length and timing of naps ⌚
Swaddle your baby 🤱
Ensure your baby is well-fed throughout the day 🍼
Create a cozy and calm sleep environment 🛏️
Children 3 – 5 years of age require between 10 -13 hours of sleep per night while those aged 6 -13 years should be logging between 9 – 11 hours of sleep.
It's important to adhere to a sleep schedule, with waking and bedtime at the same time every day including on weekends. This will ensure that your child isn’t trying to catch up on sleep for several days during the week after a couple of late nights on the weekend.
Establishing a predictable bedtime routine is helpful and can include a bedtime story and teeth brushing. Calm and relaxing activities before bed will encourage a restful sleep while simulating activities and screens like the tablet or television should be avoided for at least 1 hour before bedtime.
Exercising early in the day has been shown to help children with their energy and focus and promotes better sleep in the evening. Of course, avoid any caffeine in the afternoon and evening which is commonly found in things like soda and chocolate and might prevent your child from falling asleep.
Finally, it is important to separate sleep from other activities by designating the bed for only sleeping. If your child is having trouble getting to sleep, have them get out of bed to do something low-key such as reading a book, and returning to bed once they are sleepy again to avoid associating their bed with other activities.
Similarly, allowing children to fall asleep in places other than bed will teach their brains to associate sleep with different places. Ideally, your child should retire to bed when they are awake but drowsy.
Babies 1 year of age with difficulties sleeping should establish a healthy bedtime routine. In addition to the sleep hygiene recommendations, you can try utilizing white noise and a bedtime feeding before sleep.
These approaches are preferable to giving melatonin to your 1-year-old. If you suspect that your child’s sleep difficulties are a result of something medical, we encourage you to reach out to your pediatrician.
We examined the importance of the sleep hormone melatonin in our body's natural sleep-wake cycle. We took a look at if and when it is appropriate to supplement with melatonin and if it is safe for your baby.
Melatonin is generally considered safe for short-term use, but potential adverse effects and the need for further research into long-term safety should be considered. However, when it comes to melatonin use in babies and children, a holistic approach that considers the behaviors that might impact sleep and emphasizes good sleep hygiene is your first defense against sleep problems.
As a parent, you want to avoid the overuse of medications unless the consumption of melatonin is medically recommended by a pediatrician for your infant.
Disclaimer:
Please be aware that this information is based on general trends in babies, and it is not medical advice. Your doctor should be your first source of information and advice when considering any changes to your child’s formula and when choosing your child’s formula. Always consult your pediatrician before making any decisions about your child’s diet or if you notice any changes in your child. Breastfeeding is the best nutrition for your baby because breast milk provides your child with all the essential nutrients they need for growth and development. Please consult your pediatrician if your child requires supplemental feeding. |
Dr. Agustina Fernandez earned her medical degree from the prestigious Universidad Nacional de Córdoba, Argentina. With a deep-rooted passion for pediatrics, Dr. Fernandez is currently on the path to specializing in children's healthcare. Recently, she has delved into the vital field of infant nutrition. Her research interests include breastfeeding, infant formula, and baby food in little ones’ formative years. Dr. Fernandez's commitment to this area of study underscores her dedication to ensuring the health and well-being of children from their earliest days.
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Read MoreDr. Hsu received his medical degree from Tufts University in Boston, Massachusetts, and holds a Master’s of Science degree from both Harvard University and Tufts University.
Dr. Hsu did research in MRI neuroimaging research of fetal brains at Boston Children’s Hospital, an affiliated hospital of Harvard Medical School. Dr. Hsu is currently a full-time medical writer and consultant.
Outside of the medical profession, Dr. Hsu loves to write, learn new languages, and travel