Pediatricians advise against melatonin as a sleep aid

When children just don't want to or can't fall asleep, colorful gummy bears with melatonin are supposed to help - and thus also relieve stressed parents. The sweet sleep aid is currently a trend on social media - but pediatricians consider it risky and warn against it.

In the Tiktok video, the woman secretly mixes melatonin gummy bears into a bag of sweets and hands them to her child. Cut to the next sequence: the child is lying in his bed, fast asleep. There are plenty of videos like this on social media. With titles such as "How to get your child to sleep in under 5 minutes", parents advertise food supplements containing melatonin as an absolute miracle cure for children who simply don't want to fall asleep.

In fact, melatonin plays a key role in helping children fall asleep. The natural hormone is produced in the pineal gland in the human brain and is activated when it gets dark. "Everyone knows that vitamin D is the hormone of the day," explains pediatrician Ekkehart Paditz, who is a member of the German Society for Sleep Medicine and Sleep Research (DGSM). "Melatonin is the antagonist, the hormone of the night."

Many over-the-counter food supplements containing melatonin can be found on the internet and in drugstores, most of them for adults. They promise to help you fall asleep quickly and put an end to insomnia. They are available in the form of tablets, sprays, teas, drops and gummy bears.

Little is known about melatonin metabolism in infants

Pediatrician Paditz advises against giving one of these products to your own children without consulting a doctor. So far, too little is known about the breakdown pathways of melatonin in infants and young children, says the doctor. What is certain is that their melatonin metabolism is slower. In addition, there are considerable fluctuations in concentration with the food supplements tested in studies. "It would be fatal for parents to spend money on any sachets that are not available via the doctor's prescription pad or the pharmacy."

More than 700 products containing melatonin have been reported to the Federal Office of Consumer Protection and Food Safety (BVL) since 2011, according to a spokesperson. However, this does not mean that every product has been placed on the market. According to Paditz, there have been several infant deaths in the USA in recent years that have been linked to greatly increased melatonin levels. In one US study, researchers reported, among other things, a case in which parents regularly gave their three-month-old child between eight and ten doses of a high-dose melatonin product per day. Whether an overdose of the hormone led to the child's death could not be conclusively determined.

If, then by prescription

If children suffer from serious sleep disorders, parents should not rely on over-the-counter remedies, says Paditz. "Parents are taking quite a risk that potentially serious illnesses will be overlooked." A brain tumor, for example, can also cause sleep disorders. The pediatrician therefore advises: "Children should see a pediatrician."

For affected children and adolescents, melatonin can be prescribed by prescription. A corresponding medication for children from the age of two has been available in Germany for several years. "An approved medication that is dispensed via the pharmacy naturally offers a much higher level of safety," says Paditz. The costs of the drug are only covered by health insurance in two specific cases. On the one hand, this applies to children with autism spectrum disorder, in which, according to Paditz, between 20 and 40 percent suffer from sleep disorders. Secondly, the costs are covered for minors with Smith-Magenis syndrome, a rare disorder in which the day-night rhythm is disturbed.

Dose as low as possible

According to Paditz, the dose should generally be as low as possible. Depending on age, he recommends taking between 0.25 and 0.5 milligrams of the melatonin medication before going to bed. At the annual congress of the DGSM, which will take place between December 7 and 9 in Berlin, he and his colleagues plan to present a medical guideline on the use of melatonin in children and adolescents with sleep disorders.

According to the manufacturers, some of the gummy bears with melatonin contain between 0.5 and 1 milligram of melatonin per fruit gum.

The medication is rarely used in practice, says Jakob Maske, spokesperson for the Professional Association of Pediatricians and Adolescent Doctors. "Sleep disorders requiring treatment mainly occur in severely chronically ill children with mental disabilities who have difficulty falling asleep at a young adolescent age," says the pediatrician. He warns against using melatonin uncritically.

It is much more important to find out the cause of the sleep disorder during a visit to the doctor. "We see time and again that children and adolescents have problems falling asleep because they use their cell phones excessively or watch movies before going to sleep," says Maske. "Most of the time, the problems go away if parents follow the tips for introducing sleep hygiene."

According to Paditz, this includes developing routines and calming down before going to sleep. After all, stress, worries and fears also play a role in falling asleep. Parents could stroke children's heads soothingly at bedtime, read them a book or sing them a lullaby.

Read also:

Despite its role in inducing sleep, pediatrician Ekkehart Paditz cautions against using melatonin gummy bears as a sleep aid for children, as there's limited understanding of melatonin metabolism in infants and young children, leading to potential risks and fluctuations in concentration.
A US study reported a case where parents regularly gave a three-month-old child high-dose melatonin gummies, leading to concerns about overdose and potential link to the child's death, although the cause was not definitively determined.
In the treatment of children with serious sleep disorders, pediatricians strongly advise against relying on over-the-counter remedies due to potential health risks. Instead, children should undergo a medical examination and, if necessary, receive a prescription for melatonin medications, which are available in approved forms for children aged two and above.

Source: www.ntv.de