At what age can I give melatonin (melatonin) to a child?

Melatonin Use in Children: Age Guidelines

Melatonin should not be given to children under 2 years of age, and should only be considered in children over 2 years old after sleep hygiene and behavioral interventions have failed. 1

Age Considerations for Melatonin Use

• Under 2 years: Not recommended at any dose
• 2-18 years: May be considered only after non-pharmacological interventions have failed

Appropriate Approach to Pediatric Sleep Problems

First-Line Approach (Before Considering Melatonin)

1. Sleep hygiene practices:

   • Consistent bedtime routine
   • Regular sleep schedule
   • Appropriate sleep environment (dark, quiet, comfortable temperature)
   • Limiting screen time before bed
   • Avoiding caffeine

2. Behavioral interventions:

   • Bedtime fading
   • Extinction techniques
   • Positive reinforcement for good sleep behaviors

When to Consider Melatonin (Age 2+ only)

Only after sleep hygiene and behavioral interventions have been inadequate:

• For children with sleep onset insomnia (difficulty falling asleep)
• When administered 30-60 minutes before bedtime
• Starting with low doses (typically 1mg)

Important Cautions

• Lack of regulatory oversight: Melatonin is sold as a supplement in many countries, not a regulated medication 2
• Inaccurate labeling: Studies show actual melatonin content often differs from label claims 2
• Limited safety data: Long-term safety data in children is scarce 3
• Medical supervision required: Melatonin use should be monitored by pediatricians to evaluate efficacy and adverse effects 1

Common Misuses to Avoid

Many parents administer melatonin without medical guidance for inappropriate reasons:

• 50% of parents initiate melatonin use on their own without medical recommendation 4
• Parents often use melatonin for unsupported indications like "more restful sleep" or to make children sleep later 2
• Some parents use melatonin to facilitate changes in sleep routines (17.5%) or change circadian rhythms (11.4%) without medical guidance 4

Monitoring and Follow-up

If melatonin is prescribed for a child over 2 years old:

• Regular follow-up is essential to evaluate effectiveness
• Monitor for potential adverse effects
• Reassess the need for continued use
• Consider discontinuation trials to determine if still needed

Expert Consensus

The most recent expert guidance from the International Pediatric Sleep Association (IPSA) and European pediatric sleep specialists emphasizes that melatonin should be used only after non-pharmacological approaches have failed in children over 2 years of age 1, 5.