Melatonin Overdose in Kids: Essential Advice for Parents

If melatonin is in your medicine cabinet, heed this important message: accidental ingestions by children have risen dramatically. According to recent reports shared by the Centers for Disease Control, the increase has coincided with a significant uptick in melatonin sales: 

• 530% increase in poison center calls for pediatric melatonin exposures from 2012 to 2021
• 420% increase in emergency department visits for unsupervised melatonin ingestion by infants and children from 2009 to 2020
• $821million melatonin sales in 2020, compared to $285 million in 2016

If you use melatonin for yourself, or for your children, here’s some important information to help keep your family safe. 

Talk to your provider first.

Melatonin is a natural hormone that regulates the sleep-wake cycle. Just because it’s natural doesn’t mean melatonin is completely harmless. Consider these factors: 

• Melatonin dosing has not been standardized by an FDA-regulated process.
• Melatonin can interact with some medications, including antidepressants, antihistamines, blood pressure medications and blood thinners. 
• Long-term effects of melatonin use in children are not fully understood, such as how it may affect the development of the body's natural melatonin production. If children take melatonin for long periods of time, the child gradually requires a higher and higher dose. This usually results in having to take a “medication vacation,” or stop melatonin use altogether for a couple weeks. 
• Melatonin doesn’t help everyone sleep. Melatonin is only used to help a child fall asleep, it does not keep them asleep and, for some people, taking melatonin does little or nothing. 
• Melatonin should never be taken if you are pregnant or breastfeeding. 

It’s always best to talk to your provider before taking any supplement, and it’s even more important for children. Many sleep problems can be better managed with a change in schedules, habits, or behaviors such as improved bedtime routines. 

If melatonin is recommended, your provider can determine the proper melatonin dose. A child’s dosage needs to be based on the child’s age, weight and other factors. 

Know what’s in the bottle. 

Melatonin is regulated as a supplement, not as a medication. That means the FDA does not have oversight over purity of ingredients or accuracy of dosage. 

While it’s easily available over the counter, the actual melatonin content in supplements can vary widely. Melatonin content ranged from less than one-half to more than four times the amount stated on the label in a study cited by the American Academy of Sleep Medicine (AASM). 

The AASM recommends selecting a product with the USP Verified Mark.

• Ths voluntary program indicates that the supplement was produced in a facility following the Good Manufacturing Practice (GMP) standards. 
• USP Verified mark products meet some quality control measures, including containing the amount of an ingredient on the label without harmful levels of specific contaminants. 

Store your melatonin safely.

Because melatonin can come in the form of gummies, it can be a magnet for children who think it’s candy. Be sure to store these supplements as you would any medication. 

• Do not leave melatonin on the counter or where children can reach it. 
• Keep melatonin in its original container.
• Store in a high, locked cabinet.

It’s important to also talk with children about medicine safety in an age-appropriate way.

Know the signs of overdose.

Approximately 11,000 infants and young children taken to emergency rooms after accidentally taking melatonin from 2012 to 2022. Hospitalizations and more serious outcomes due to melatonin also increased. 

Symptoms include:

• Headaches
• Dizziness
• Nausea
• Daytime sleepiness
• Mild depression

If you suspect your child has taken melatonin or is demonstrating symptoms of overdose, call the Poison Control Center at 800-222-1222 or go to an emergency room right away. 

If you have additional question, reach out to your child's provider or pediatrician.

Sources:

https://www.cdc.gov/mmwr/volumes/71/wr/mm7122a1.htm

https://www.cdc.gov/mmwr/volumes/73/wr/mm7309a5.htm

https://aasm.org/advocacy/position-statements/melatonin-use-in-children-and-adolescents-health-advisory/

https://www.poison.org/articles/too-much-melatonin