Experts warn melatonin isn’t the answer for children’s sleep struggles

While melatonin is commonly used by parents to help children sleep, experts caution against its routine use without medical guidance, emphasising behavioural approaches and potential risks involved.

Many parents reach for melatonin when bedtime becomes a battle, but experts say it should not be the default answer for children who struggle to sleep. Dr Michelle Caraballo, a paediatric pulmonologist and sleep medicine specialist, argues that the first step is usually to look at routine, screen use and other habits that may be making sleep harder. According to the American Academy of Pediatrics, families should speak with a paediatrician before using melatonin at all.

Melatonin is a hormone the body makes naturally to help regulate the sleep-wake cycle, but it mainly helps with falling asleep rather than staying asleep through the night. That distinction matters, because a child who wakes often, goes to bed at different times or uses devices late at night may need changes in behaviour rather than a supplement. The Mayo Clinic Health System and the Sleep Foundation both note that melatonin may help some children drift off more easily, but it is not a fix for broader sleep problems.

Caraballo says melatonin may have a place for some children, particularly those with developmental or neurological differences, including autism or ADHD, but only with medical guidance. The National Center for Complementary and Integrative Health says it should not be given to children under three, while the Sleep Foundation says extra caution is needed for children with certain health conditions. Doctors also stress that more is not better; dosing should be individualised and carefully monitored.

Safety is another concern. In the United States, melatonin is sold as a dietary supplement, which means the Food and Drug Administration does not review products for purity or exact dosing in the same way it does prescription medicine. The American Academy of Pediatrics recommends looking for third-party testing labels such as USP, NSF or ConsumerLab. Caraballo also warns that gummies can look like sweets to young children and may be more likely to be swallowed by mistake.

Possible side-effects include nightmares, headache, dizziness, nausea, irritability and increased bedwetting, according to the NCCIH. There are also concerns about long-term use, including possible effects on puberty and development, which is why major paediatric groups say more research is needed. Poison centres have also reported a sharp rise in accidental melatonin ingestions in recent years, with the CDC linking serious outcomes largely to children aged five and under.

Before turning to supplements, experts recommend the basics: a steady bedtime and wake time, a dark and quiet room, no screens for one to two hours before bed and a calming routine such as reading or quiet music. If sleep still does not improve, parents should raise the issue at a routine paediatric visit. Poor sleep can affect mood, attention and learning, so the aim is not simply to make a child drowsy, but to find and treat the real cause of the problem.