Physicians warn against giving melatonin to children - WALB.com, Albany News, Weather, Sports

Physicians warn against giving melatonin to children

Sleep aids are a multi-billion dollar business which may have a new set of customers – children.

Parents desperate to get their troubled sleepers to bed are turning to synthetic melatonin, which is a supplement sold over the counter.

The body's internal clock is coordinated by the hormone melatonin, essentially telling the body when to go to sleep and when to wake up.

Available in pill form, adults can self-prescribe melatonin to ease insomnia or jet-lag. Melatonin can help an individual get their body in sync with their environment.

A growing number of parents are now giving the supplement to their children who have trouble going to sleep.

Michael Smith is a naturopathic physician and founder of Carolinas Natural Health Center in Charlotte, North Carolina.

"I think long-term use to force your child to get to sleep doesn't make sense," Smith warns.

While melatonin naturally occurs in the body, synthetic melatonin has not been medically endorsed for use in children.

Sold as a dietary supplement, FDA approval or regulation of manufacturers is not required.

According to the National Institutes of Health, "Melatonin should not be used in most children. It is possibly unsafe. Because of its effects on other hormones, melatonin might interfere with development."

Most studies evaluating children who have used melatonin have been with those dealing with a developmental disability.

In these cases, melatonin use had some success, but these children either didn't produce the hormone at all or, at least, not efficiently.

"Beyond that, we need to start looking at what's really the issue with the child--what's going on here?" Smith says.

Before administering any supplement to a child, Smith recommends parents alter their child's bedtime behaviors first.

Eliminating caffeinated drinks, and limiting television and bright electronic screens before bedtime are all tried-and-true techniques with no side effects.

The side effects of melatonin use include headaches, drowsiness and stomach ache.

While you may be desperate to get your children dreaming, before tucking them in with help from any sleep aid or treatment, consult with your child's pediatrician first.

There may be a medical reason for your child's sleep troubles, like a breathing problem, and yet one more reason why it's so important to seek your family doctor's advice.

Additional Information:

The following information is from the National Sleep Foundation (Source: http://www.sleepfoundation.org/article/sleep-topics/melatonin-and-sleep).

  • No other hormone is available in the United States without a prescription. Because melatonin is contained naturally in some foods, the U.S. Dietary Supplement Health and Education Act of 1994 allows it to be sold as a dietary supplement (e.g., vitamins and minerals). These do not need to be approved by the Food and Drug Administration (FDA) or controlled in the same way as drugs.
  • Because it is not categorized as a drug, synthetic melatonin is made in factories that are not regulated by the FDA. Listed doses may not be controlled or accurate, meaning the amount of melatonin in a pill you take may not be the amount listed on the package. Most commercial products are offered at dosages that cause melatonin levels in the blood to rise to much higher levels than are naturally produced in the body. Taking a typical dose (1 to 3 mg) may elevate your blood melatonin levels to 1 to 20 times normal. Side effects do not have to be listed on the product's packaging. Yet, fatigue and depression have occasionally been reported with use of melatonin.

The following information is from the website WebMD (Source: http://www.webmd.com/vitamins-supplements/ingredientmono-940-MELATONIN.aspx?activeIngredientId=940&activeIngredientName=MELATONIN).

  • Melatonin is most commonly available in pill form, but melatonin is also available in forms that can be placed in the cheek or under the tongue.
  • Melatonin is used for jet lag, shift-work disorder, helping blind people establish a day and night cycle, insomnia, delayed sleep phase syndrome, insomnia associated with attention deficit-hyperactivity disorder, sleep problems in children with developmental disorders including autism, cerebral palsy, and mental retardation.
  • Melatonin has been used for Alzheimer's disease, ringing in the ears, depression, chronic fatigue syndrome, fibromyalgia, migraine and other headaches, irritable bowel syndrome, bone loss, tardive dyskinesia (TD) and epilepsy.
  • Melatonin has been used for cancer treatment in breast, brain, lung, prostate, head, neck and gastrointestinal cancer.
  • Melatonin is likely safe for most adults when taken by mouth short-term or applied to the skin. It can cause some side effects including headache, short-term feelings of depression, daytime sleepiness, dizziness, stomach cramps, and irritability. Do not drive or use machinery for four to five hours after taking melatonin.
  • Melatonin is possibly unsafe in pregnancy. Don't use it. Melatonin might also interfere with ovulation, making it more difficult to become pregnant.
  • Melatonin should not be used in most children. It is possibly unsafe. Because of its effects on other hormones, melatonin might interfere with development during adolescence.

The following information is from the Mayo Clinic (Source: http://www.mayoclinic.com/health/melatonin-side-effects/AN01717).

  • Some research suggests melatonin might be helpful in treating jet lag or reducing the time it takes to fall asleep — although the effect is typically mild. It may be more effective for delayed sleep disorder or sleep disorders affecting circadian rhythm.
  • Common side effects include: daytime sleepiness, dizziness and headache. Less common side effects include abdominal ache, mild anxiety, irritability, confusion and short-term feelings of depression.
  • Melatonin supplements can interfere with blood-thinning medications, immunosuppressants, diabetes medications and birth control pills.
  • Check with your doctor first. Choose commercial supplements made in a lab. Avoid activities that require alertness (driving, operating heavy machinery) for four to five hours after taking.

The following information is from a news report published by NBC Connecticut (Source: http://www.nbcconnecticut.com/investigations/Doctors-Warn-Parents-About-Melatonin-for-Kids-167339615.html).

  • Melatonin is a hormone that is secreted by your brain. It's present in every person's body.
  • It is produced at a higher rate at a young age.
  • Despite the fact that it is naturally occurring, toxicologists say the manufactured supplements have not been clinically proven to be a healthy sleep agent.
  • Many bottles claiming "helps promote sleep" actually have a disclaimer on the back that the statements have "not been evaluated by the Food and Drug Administration."
  • The Council for Responsible Nutrition says that melatonin has a strong safety profile but should only be given to children as a sleep aide in consultation with a doctor or other healthcare provider.
  • Examine bedtime routines, exposure to bright screens, exercise and diet before taking melatonin

The following information is from NaturalSleep.Org (Source: http://www.naturalsleep.org/is-melatonin-safe-for-children/).

  • Melatonin is a natural hormone/neurotransmitter in the human body that is produced in the pineal gland.
  • Melatonin levels peak in the late afternoon/evening and drop during the day time, thereby regulating the natural circadian rhythm or sleep cycle, of humans.
  • Upon exposure to light, melatonin is rapidly destroyed.
  • Supplementing melatonin in children has not been medically verified since it is a fact that children have the highest natural levels of melatonin.
  • Exercise caution and use small doses.
  • Success has been seen in cases of autism and ADHD where the child is having sleep problems.
  • Safe for children with little to know side effects but should only be used for a few weeks - safety has not been evaluated for longer periods.]
  • A range of 0.3mg to 7mg is advised but that varies depending on who you ask.
  • Do not give melatonin to a child under 10 years old.
  • Side effects include: daytime drowsiness, headaches, upset stomach.
  • Do NOT use if the child has auto-immune disease, diabetes or is on any anti-epileptic/psychotherapeutic drugs.
  • Best used as a last resort.
  • First try avoiding caffeinated foods and drinks, encouraging a routine and discouraging use of TV and electronics.

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