Using Melatonin for Kids: Safety and Effectiveness

To some extent, yes. A 2013 meta-analysis found that people with insomnia fell asleep about 7 minutes faster when they took melatonin. But that study was in both adults and children, and the researchers said there was not enough data on children to analyze the relationship between age and efficacy.

Much of the research suggesting melatonin might be helpful in children has focused on kids with autism or on sleep problems related to attention-deficit/hyperactivity disorder, rather than in kids whose primary issue is sleeplessness, Canapari says. In such kids, it’s generally “given a half hour before bedtime and helps the transition from wake to sleep,” says Judith A. Owens, MD, senior faculty in sleep medicine at Boston Children’s Hospital.

Research also suggests that melatonin taken in small doses at certain times can help older kids with delayed sleep cycles, where they consistently go to bed late and wake up late. 

Kids with sleep-onset insomnia, who usually take longer than 20 to 30 minutes to fall asleep at night, may also benefit from melatonin’s sleep-inducing effects, according to Anna E. Esparham, MD, a pediatrician at Children’s Mercy Hospital and an associate professor of pediatrics at the University of Missouri-Kansas City School of Medicine.

But while melatonin may make for an easier bedtime, it doesn’t affect sleep quality, Canapari says. 

He discourages relying on it, especially as a replacement for good bedtime practices like sticking to a regular sleep-wake schedule and maintaining a relaxing bedtime routine—which should include avoiding screen time for a few hours before bed, Esparham says. “Even a very potent hypnotic drug won’t work that well if your child or household are doing things that negatively interfere with sleep quality,” Canapari says.

Scientific research about the long-term safety of melatonin use is scant, and how long-term use might affect kids’ development is still unknown, according to Esparham. 

Melatonin is a hormone, so the primary concern is that persistent use could delay puberty or cause premature sexual development. “Melatonin has an impact on the [hypothalamic-pituitary-gonadal axis], which governs the development of pubertal changes,” Owens says. “In theory, melatonin could affect that.”

A 2021 study of melatonin in children with autism found no negative impact on hormonal development over the course of two years. In a longer-term study of young adults who took melatonin for an average of about seven years, some participants reported delayed puberty. But this was a retrospective study and was not designed to show cause and effect. 

In the short term, Esparham says, melatonin isn’t likely to cause serious side effects, though some kids may experience daytime sleepiness or even develop nighttime bed-wetting. 

Finally, parents should be aware that supplements are not regulated in the same way as drugs and that the Food and Drug Administration does not verify that supplements contain what they say they do before they go to market. 

Research has even found issues with melatonin supplements in Canada, where supplements are regulated more like drugs. In one Canadian study published in 2017, researchers found that the melatonin content in most of the melatonin supplements they purchased was off by 10 percent or more from what was listed on the label. One tablet in chewable form, which may be a popular format for children, contained almost 9 mg of melatonin instead of the 1.5 mg listed on the label. Groups like US Pharmacopeia (USP) and NSF International do verify the contents of certain supplements, so you can look for their mark on the label when you’re shopping.

“With a heavy dose of caution, melatonin in the short run, for three to six months, seems to be relatively safe from the standpoint of short- or long-term side effects,” Owens says. “But we simply don’t have the data to make a definitive statement about it.”

The American Academy of Pediatrics recommends discussing the possibility of using melatonin with your child’s doctor before starting a supplement. A pediatrician can rule out medical issues that may interfere with sleep, such as anxiety or sleep disorders, along with recommending healthy sleep routines. If you do decide to buy melatonin after consulting with your child’s pediatrician, see our tips on how to choose a supplement. 

The maximum dose of melatonin for children who weigh less than 88 pounds, Canapari says, is 2 mg. The maximum for kids who weigh more than that is 5 mg. Still, Canapari recommends using the lowest dose for the minimum amount of time possible. “Kids who are sensitive to melatonin need very little, so if you start on a low dose, they may not need more,” Canapari says. 

Be mindful, too, of your own expectations for how long your child should be sleeping. While ample sleep is an important part of well-being, some kids just need less sleep than their peers. If your child isn’t falling asleep at night, melatonin may be a short-term solution, but it won’t necessarily solve the real problem. Instead, it’s best to focus on supporting long-term behaviors that help kids fall and stay asleep. “Even though we prescribe melatonin as doctors, we really try to focus on retraining kids’ sleep habits,” Esparham says.