Is Melatonin Safe For Kids Theres Little Research On That
Because melatonin is a hormone, there are concerns about how taking it might affect a childs growth and development, particularly during puberty. When you look through the literature, all of the feedback that you get is very positive. It seems to be safe, says Cummings. The problem is, if you look at the number of studies and the number of subjects in the studies, they are actually quite small numbers. So its reassuring, but only to a point.
Better Sleep For Baby
Kara Cantrell knew she was in trouble by the second night after her son was born. “He screamed through the night,” remembers the 41-year-old actor from Atlanta. “I’dhad a 4-day labor and C-section and was just a mess. And there was this screaming creature and I didn’t know what to do.”
A couple months later, things weren’t much better. Just when her son seemed to be settling into a sleep pattern, he’d switch things up. “Suddenly he’d get up six times a night, or he’d sleep miraculously for 10 hours,” Cantrell says.
About the only thing parents can predict about their newborn‘s sleep cycles is that they’ll be unpredictable. “When babies are first born they’re all over the place,” says Jodi Mindell, PhD, associate director of the Sleep Center at the Children’s Hospital of Philadelphia and author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night’s Sleep. Hunger — or a lack of it — usually determines when a newborn sleeps and wakes. By around 3 months, babies start making the hormone melatonin, which puts their sleep cycle into a more regular rhythm.
Are There Other Ways To Help Your Child Sleep Better
Melatonin has often been called the hormone of darkness because darkness triggers its release. It is suppressed by light, including the blue light emitted by digital screens. So one of the best ways to help a childs brain get sleepy is to dim the lights in your home and turn off those omnipresent screens an hour before bedtime.
Its also helpful to get exposure to bright light during the day, since sunlight helps regulate our sleeping patterns. When people are exposed to light in the morning, regardless of whether its sunlight or very bright artificial light, it helps nighttime melatonin production.
Try to keep a structured, consistent bedtime routine to preserve your childs sleep-wake schedule. For children 6 and under, difficulty sleeping is often a behavioral issue, experts said, and behavioral solutions might work.
To help your child fall asleep earlier, Dr. Canapari recommends making sure your child doesnt nap too late in the day. To get to sleep by 8 p.m., for example, make sure your childs nap ends before 4 p.m.
Also, match your childs bedtime to when they naturally fall asleep. Then try shifting bedtime earlier by 10 to 15 minute increments. Eventually, you will find a sweet spot, Dr. Owens said, that works for you and your child.
Dr. Canapari suggested thinking about ways to incentivize a childs time in bed and offering rewards as opposed to punishments.
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Side Effects Of Melatonin
Melatonin is considered relatively safe for short-term use and has few risks. However, some children who take melatonin supplements may experience mild symptoms. These symptoms may include bedwetting, drowsiness, headaches, and agitation.
Currently, there is little research on the long-term effects of melatonin use in children. Some experts question if melatonin, because it is a hormone, can affect other hormonal development in adolescents. Further research must be conducted to more clearly understand the long-term effects of melatonin on children.
What If My Child Needs More Help With Their Sleep
Melatonin can be helpful for some but not all sleep problems. Talk to your family doctor before using melatonin.
In most children, healthy sleep habits will sort out their sleep problems. If your child does need more help, using a medicine such as melatonin will work better if healthy sleep habits are in place.
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References: Finding The Right Infant Sleep Aid
American Academy of Pediatrics. 1997. Breastfeeding and the Use of Human Milk. Pediatrics 100 : 1035-1039.
Anders TF. 1979. Night waking in infants during the first year of life. Pediatrics 63: 860-864.
Anders TF, Halpern LF, and Hua J. 1992. Sleeping through the night: A developmental perspective. Pediatrics 90: 554-560.
Anuntaseree W, Mo-Suwan L, Vasiknanonte P, Kuasirikul S, Ma-A-Lee A, and Choprapawan C. 2007. Night waking in Thai infants at 3 months of age: Association between parental practices and infant sleep. Sleep Med. 2007 Sep 25 .
Barr RG, Pantel MS, Young SN, Wright JH, Hendricks LA, Gravel R. 1999. The response of crying newborns to sucrose: is it a sweetness effect? Physiol. Behav 66: 409-417.
Bellesi M, Riedner BA, Garcia-Molina GN, Cirelli C, Tononi G. 2014. Enhancement of sleep slow waves: underlying mechanisms and practical consequences. Front Syst Neurosci. 8:208.
Blass EM. 1997a Milk-induced hypoanalgesia in human newborns. Pediatrics 99: 825-829.
Blass EM. 1997b. Infant formula quiets crying newborns. Journal of Dev Behavioral Pediatrics. 18:162-165.
Blass EM and Watt LB. 1999. Suckling- and sucrose-induced analgesia in human newborns. Pain. 83:611-23.
Butler R, Moore M, Mindell JA. 2016. Pacifier Use, Finger Sucking, and Infant Sleep. Behav Sleep Med. 14:615-23.
Campos RG. 1994. Rocking and pacifier use: Two comforting interventions for heel stick pain. Res Nurse Health 17: 321-331.
Image credits for The infant sleep aid
What Exactly Is Melatonin
Your body naturally produces melatonin, a hormone secreted by the pineal gland in the brain, playing a key role in regulating the bodys sleep/wake cycle.1 The brain increases the production of melatonin when it’s dark and decreases its production when it’s light. That explains why being exposed to blue light in the evening can inhibit the production of melatonin2 It is best to limit exposure to blue light at least 30 minutes before bedtime.
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Other Sleep Remedy Ideas
If youre trying to get your child to go to sleep and dont want to use melatonin or other sleep aids, there are natural solutions you can attempt to employ.
There are natural conditions that help to produce melatonin in the human body. Lowering the temperature in your home by about eighteen degrees can help. So can making sure the sleeping environment of your child is as dark as possible.
Light, especially from television or other kinds of electronic screens, can make it hard for your child to get a natural and healthy sleep. TV and computer screens decrease melatonin and increase cortisol, meaning you should keep your infant away from them for up to an hour before heading to sleep.
Having a set bedtime routine for your child can help them mentally anticipate and prepare for bed. With a routine, they will relax more quickly and be ready for sleep. The above solutions wont necessarily work in the case of serious sleep disorder but can help general issues of sleep disruption.
How Effective Is Melatonin For Sleep Problems In Children
The overall effects of melatonin for children include falling asleep more quickly and an increase in sleep time. Like all medicines used to help children fall asleep, there is fairly limited information available. This means that most studies have small groups followed for short periods of time. Furthermore, melatonin not regulated as a pharmaceutical in the U.S. Thus, there is no large pharmaceutical company bankrolling larger and long-term studies . Rather it is regulated as a food supplement by the FDA. For a terrific review, including dosing recommendations, I highly recommend this article by Bruni et al.
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What Is The Take Home Should My Child Take Melatonin
I have not met a parent who is eager to medicate their child. Such decisions are made with a lot of soul-searching, and frequently after unsuccessful attempts to address sleep problems via behavioral changes. Treatment options are limited. There are no FDA-approved insomnia medications for children except for chloral hydrate which is no longer available. Personally, I use melatonin for children commonly in my practice. It is very helpful for some children and families. I appreciate Dr. Kennaways concerns but I have seen first hand the consequences of poor sleep on children and families. I always investigate to make sure that I am not missing other causes of insomnia . My end goal is always to help a child sleep with a minimum of medications. I know that this is the goal of parents as well. Some children, especially those with autism of developmental issues, will not be able to sleep without medication. So, melatonin may be a good option for your child if:
- Behavioral changes alone have been ineffective
- Other medical causes of insomnia have been ruled out
- Your physician thinks that melatonin is a safe option for your child and is willing to follow his or her insomnia over time
By the way, heres a great article from the Chicago Tribune on alternatives to melatonin.
NOTE:
You Can Encourage The Release Of Natural Melatonin In Your Kid
Melatonin is released by our pineal glands in response to darkness as a part of our circadian rhythm. There are things you can do to help your kids sleep cycle get on track so that natural melatonin gets released at bedtime. Having a dark sleep environment, a consistent bedtime and limiting screens and snacks before bed all naturally promote melatonin and bring on sleep, says McGinn.
These types of sleep practices are called sleep hygieneand Cummings says he would never recommend melatonin as a replacement for these practices. We are in an age where families are often looking for a quick fix, he says. But not everything needs a pill to get better.
*Names have been changed
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Avoiding Nighttime Light Especially The Blue Wavelengths
Research confirms that light exposure at night sends a powerful, sleep-busting signal to the brain: Stay alert. Delay the release of the hormone, melatonin, that facilitates relaxation and drowsiness.
As I note in this article, young children may be especially sensitive to the sleep-busting effects of artificial lighting, and the blue wavelengths may have the most disruptive effects.
So in the evenings, shift to dim lighting. Try to protect your baby from light exposure in the middle of the night. And use light bulbs and blue-light filters that are designed to block the blue wavelengths that are especially likely to cause sleep disruption.
How Do You Know If Melatonin Might Be Helpful
Children on melatonin should meet some criteria for insomnia, and in particular for difficulty falling asleep. But they also should have other things ruled out, experts said.
If you are worried about your kids sleep, talk to your pediatrician, said Craig Canapari, M.D., an associate professor of pediatrics at Yale University, director of the Pediatric Sleep Center at Yale-New Haven Hospital. Melatonin certainly may be on the table for a finite period of time, but you have to look and see is there an underlying problem that is causing your childs insomnia.
For example, melatonin is not appropriate for restless leg syndrome. Both the American Academy of Pediatrics and the National Institutes of Health say that children should not take melatonin long-term, but neither organization defines what long-term means. Some children naturally fall asleep later than parents might like, but that doesnt mean they need melatonin.
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Melatonin Dosage For Kids
Always talk to your child’s doctor before giving them 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 doseusually 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.
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How Melatonin Helps Babies Sleep
For babies who have trouble sleeping, it is sometimes determined that their natural melatonin levels are lower than they should be. Of course, this poses a problem when it is time to sleep, and it will need to be addressed in some way. If you choose to go the route of a melatonin supplement, you will find that the supplement encourages normal sleep cycles by normalizing the melatonin levels in your babys body.
Eventually, it is predicted that the melatonin supplement will help your babys natural sleep cycles regulate. In the meantime, melatonin for babies should be given about 30 minutes before its time to sleep.
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Safety In Toddlers & Young Children
Dr. Maida Chen, who leads the Pediatric Sleep Center summarizes this well, There have only been a few studies to look at long-term melatonin use and associated effects, but some sleep specialists consider melatonin safe, particularly for occasional short-term use. Often the child has a chronic sleep disorder and melatonin is covering up the underlying symptoms. It can be a slippery slope for families because continuing use of melatonin can delay obtaining more appropriate treatment for the underlying sleep disorder.
Generally, research finds that supplemental melatonin is not tremendously effective in children who arent diagnosed with underlying ADHD or ASD, though some kids get benefit in falling asleep more quickly. I sincerely believe that many young children getting melatonin would do better with improved consistent bedtime routines, strict rules about no emitting devices for 1 hour prior to bedtime . For any child having trouble falling asleep, work to avoid screens and/or dim the screen light in the hours before bedtime.
What Stimulates Melatonin Production In Babies And Toddlers
Since melatonin is only produced when its dark, one of the biggest things that can help to stimulate melatonin production is sleeping in a dark room. For babies and toddlers under 2 years old, we recommend having a dark room for both naps and overnight sleep. This can help your baby to settle and fall asleep quicker and link their sleep cycles too.
Toddlers and children over 2 years of age can develop a genuine fear of the dark though – in this case you may need to use a nightlight for reassurance. Where possible, we recommend using a red light, as this has been shown to have minimal impact on melatonin production. Blue light should be avoided, especially in the 2hrs before bedtime, as this suppresses melatonin more than any other colour of light.
Since the bodys circadian rhythm triggers the release of melatonin, having a consistent bedtime routine can also help to stimulate melatonin production. To establish a routine for your baby, we recommend:
- Waking them at the same time each morning to help set their body clock.
- Making sure their nap times and lengths are appropriate for their age. This helps to build sleep pressure throughout the day, so that they are able to sleep well overnight.
Bedtime battles are one of the most common sleep challenges we are asked about and whilst melatonin production can play a part in this, usually the difficulties settling are due to other factors like under or overtiredness, hunger, overstimulation or developmental leaps/milestones.
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Dont Make It The First Thing You Go For
When you are sleep deprived, you want to do anything to make sure you can get a good night’s sleep, and this can make you want to give your child melatonin so you can put them down so you can both get some rest.
According to HealthLine.com, melatonin should never be the first thing you do when trying to get your child to go to bed. They recommended soothing your baby by rocking them and feeding them milk to get them to go to sleep naturally rather than giving them medication.
Nursing A Baby To Sleep: The Ultimate Sleep Aid
Throughout human history, whether breastfed or bottle-bed, babies have been nursed to sleep. It is probably the most reliable infant sleep aid in existence.
Why is it so effective? To some degree, its obvious. Hunger is an unpleasant sensation. Sate the hunger, and a baby is going to feel more comfortable and relaxed afterwards.
But there is more to it than that.
First, it isnt just a question of calories. Newborns cry less and seem to experience less pain when they receive very small amounts of milk, formula, or sucrose . Moreover, the act of suckingeven sucking a pacifierhas a calming effect .
Second, infants who breastfeed experience skin-to-skin contact, which may be an effective infant sleep aid in its own right .
In addition, breastfeeding boosts a mothers oxytocin levels, which can enhance her maternal feelings and impart a sense of calm . Such psychological changes may make it easier for her to soothe her infant.
There is also the possibility that opens in a new windowbreastfeeding in the evening increases a babys levels of melatonin, the hormone that helps us become drowsy .
So feeding can be a powerful infant sleep aid. Yet it is controversial. Why?
One reason concerns the question of timing.
Parents who use feeding as an infant sleep aid may tend to feed their infants more often, and some researchers believe high-frequency feedings could interfere with the development of longer sleep bouts at night.
The other source of controversy concerns self-soothing.
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