Photo-Illustration: The Cut; Photos: Getty
It was bedtime at the campsite we were sharing with four families when the kids formed a conga line, one hand clutching a s’more, the other on the tiny shoulder of the person in front of them. The other families had camped together before; ours hadn’t. “Gummy, gummy, gummy!” the kids began to chant. Apparently, it was melatonin o’clock.
I let my then-5-year-old take a gummy. After all, it can be hard to fall asleep in a tent, especially in the summer, when the sun doesn’t set until nearly 9 p.m. Plus melatonin is a naturally occurring hormone that the brain produces to regulate the sleep-wake cycle. It’s been available for purchase since the mid-’90s. And everyone else was doing it — and not just at the campsite. As of last year, nearly one in five school-age children had taken the supplement in the past 30 days, according to 2023 research published in JAMA Pediatrics. And of those kids, one in four had taken it every night.
Within minutes of eating hers, my daughter was passed out, as were all the other kids, even the “horrible sleepers.” I could see how a parent and their kid could get hooked. No more calls for water or back rubs or stories or a podcast. No need to sit on the floor in comforting silence like a human security blanket. When children take melatonin, it can make them fall asleep soon after. Melatonin, parents tell me, vanquishes the bedtime struggle and eases tension in the household for everyone.
The negative impact of melatonin on kids’ health remains more of an amorphous possibility than a concrete inevitability, which partly explains why so many well-informed parents and caregivers continue to ignore or downplay negative headlines. The American Academy of Pediatrics notes somewhat opaquely that “there are concerns about how it might affect a child’s growth and development” when used at length. “We just don’t know for sure what the impact is, and that’s the problem,” says Lauren Hartstein, Ph.D., a postdoctoral fellow at the University of Colorado Boulder Sleep and Development Lab, who adds that there’s a shortage of research on the long-term effects of regular melatonin use by children and that the research that does exist has been fairly inconclusive. Participants in a 2018 study reported delayed puberty after taking the hormone for an average of seven years as children. In animal studies, melatonin has been shown to suppress the secretion of gonadotropin-releasing hormone, which stimulates the production of other hormones that help the ovaries and testicles mature and function. The body’s nocturnal secretion of melatonin tends to drop throughout childhood, paralleling the progression of sexual maturity. Raise the former, and you may be slowing the latter. And a 2022 study concluded that “whether or not melatonin could play an important role in the pubertal onset in humans is still an open question.”
The contents inside the gummy bottles are also a question mark, though the packaging tells a straightforward and cheerful story. Olly, which makes kids’ sleep gummies, as well as gummies made for kids to “chillax” and lollipops for a “calm mood,” packages its sleep gummies in square jars — the word sleep is in all caps, many font sizes bigger than the list of actual ingredients. Nature’s Bounty, meanwhile, calls its Kids Sleep Jelly Beans “a fun and delicious way to promote peaceful sleep in children.”
But melatonin supplements can contain up to 347 percent of the melatonin they say they do, according to a 2023 research letter published in JAMA. (Although melatonin is a naturally occurring hormone, most melatonin supplements are made by synthesizing pharmaceutical-grade chemicals.) And 26 percent of melatonin supplements contain significant doses of serotonin, which can cause agitation, increased heart rate and blood pressure, and nervous-system dysfunction, says Varun Vohra, Pharm.D., the academic and managing director of the Michigan Poison and Drug Information Center and a co-author of a 2022 melatonin report from the CDC.
Consumers filed a class-action lawsuit last year claiming that Olly adult melatonin supplements contain as much as 274 percent more melatonin than the stated amount, and Procter & Gamble is being sued for allegedly selling melatonin supplements that contain up to 163 percent more melatonin than users think they’re getting. A third lawsuit alleges that Zarbee’s children’s melatonin gummies specifically contain more than twice the one-milligram amount listed on the label. “Parents have been having concerns about kids’ sleep for an eternity,” says Hartstein. What’s changed, she says, is that “melatonin is being heavily marketed to parents as a quick fix.” Momfluencers who are #toddlermoms and do a lot of #familytravel are often a proud #ZarbeesPartner or #NatrolPartner, crediting the company’s melatonin gummies for easier bedtimes and “better-rested kiddos.”
There is an approved medical usage for melatonin, and it’s to treat something called delayed sleep-phase syndrome. Children with this syndrome, for largely unknown reasons, fall asleep two or more hours later than a typical bedtime. In that situation, a sleep-medicine specialist might recommend giving .5 milligrams of melatonin four-to-five hours prior to bedtime, says Tessa Scripps, M.D., a pediatrician and assistant professor of pediatrics at the Mount Sinai Kravis Children’s Hospital in New York. But Scripps says parents rarely follow that advice. Instead, she says, “They give them a gummy right before bed.” Melatonin taken close to bedtime likely relies on the sedative effect of larger doses (over one milligram) versus the “sunset effect” of smaller ones. According to one study, .5 milligrams of instant-release melatonin works best when administered four-to-six hours before “sleep initiation.”
As melatonin gummies enter more homes and as children increasingly realize they taste almost identical to regular gummy candy, some kids are sneaking them by the fistful. The number of calls to poison-control centers for pediatric melatonin ingestions climbed 530 percent from 2012 to 2021, according to a 2022 CDC report. And a 2024 report from the CDC found that approximately 11,000 pediatric ER visits between 2019 and 2022, or 7 percent of the total, were for unsupervised melatonin ingestions. (Typically, kids are asymptomatic, though there have been recorded incidents of gastrointestinal, cardiovascular, and CNS symptoms.) Melatonin overdoses have become so frequent that the Council for Responsible Nutrition, the leading trade association for the supplement industry, is now calling for manufacturers to start using child-deterrent packaging for flavored, chewable melatonin products. As a dietary supplement, melatonin is not FDA regulated and doesn’t have to be in childproof packaging; CRN’s new guidelines are recommendations, not requirements.
One friend whose preschool-age daughter quietly helped herself to melatonin gummies without permission (she was fine) received a visit from Child Protective Services after casually telling her day-care provider about it the next morning. “It was a horrifying experience, obviously,” she told me. “CPS opened up an investigation and made us put all the children’s medicine into a lockbox.”
Brooke, who works in financial communications and lives in Easton, Connecticut, started giving her now-15-year-old son melatonin when he was 5. “His pediatrician neither supports nor dissuades him from taking it,” she says. “He still takes a very low dose, so I often wonder if it’s almost a placebo effect. But he claims he’s unable to sleep without it.”
While there’s no research to suggest that people can become physically dependent on melatonin, many kids like Brooke’s son and their parents have become convinced that sleep is elusive without it. They are, in a sense, psychologically dependent. Some child-care providers have become so reliant on the supplements they’ve broken the law in favor of no-struggle sleep. In February, a former day-care director in Indiana was sentenced to six months in jail for handing out melatonin gummies to more than a dozen kids at nap time without their parents’ consent. And last month, the owner of a New Hampshire day care was arrested along with three of her employees for sprinkling melatonin onto children’s food.
Amy, a Brooklyn architect, first gave her son melatonin when he was 6. “He was having a lot of behavioral problems and got a provisional ADHD diagnosis. We realized he was getting only around nine hours of sleep per night, and his doctor suggested it,” she says. (Studies have shown that melatonin can be beneficial for children with autism and ADHD, who tend to have a disordered circadian rhythm.) “A year later, that same doctor was like, ‘Wait, melatonin is not supposed to be used long term!’ He basically told me what I’d already read by that point, which is that there are no long-term studies on it.”
Experts worry about the behavioral and medical problems melatonin may be papering over. “I so understand wanting to quickly restore some sanity to your household by ordering something that will be at your door in two hours. I have three kids, and I’ve climbed into the crib before,” says Cora Breuner, M.D., an attending physician at Seattle Children’s Hospital and a professor of pediatrics at the University of Washington School of Medicine. “But teaching your kids how to fall asleep on their own is right up there with seat belts and covered outlets and introducing foods at the right time as one of the most important things parents can do,” she says.
Amy’s son is now 9, and he’s still taking melatonin most nights. “These days, the problem isn’t so much behavioral issues as it is that he’s become dependent on it,” she says. She’s trying to wean him off it with mixed results. “There have been nights when we don’t give it to him, and the difference is dramatic,” she says. “He’s flailing, and he’s doing headstands and singing. He’ll ask for melatonin, and I’ll start out by saying ‘no.’ But an hour later, he’s everywhere, so I’ll just give it to him in spite of the fact that I remain conflicted about it.”
All names of parents and children have been changed to protect their identities.
Related
10 Sleep Experts on What to Do When You Can’t Sleep at NightThe Parents Who Dread Their Kids’ Bedtime
Juno DeMelo , 2024-06-24 14:00:20
Source link