From the Guidelines
It is not recommended for a 2-year-old to take melatonin without a doctor's supervision. According to the American Academy of Sleep Medicine clinical practice guideline 1, the use of melatonin in pediatric populations is still uncertain due to the lack of rigorous long-term data. While a dose of 0.15 mg/kg taken 1.5–2.0 hours prior to habitual bedtime for 6 nights showed optimal results, the benefits/harms assessment is uncertain, particularly in the pediatric/adolescent population.
Some key points to consider when evaluating the use of melatonin in a 2-year-old include:
- The developing brain of a 2-year-old produces melatonin naturally, and introducing synthetic versions could potentially disrupt normal hormone development
- Melatonin is not FDA-approved for use in children of any age, and there are no established safe dosages for toddlers
- Relevant concerns have been raised by select studies with respect to the pediatric/adolescent population, highlighting the need for caution when considering melatonin use in young children
Instead of melatonin, parents should first try establishing consistent bedtime routines, maintaining a regular sleep schedule, creating a calm sleep environment, limiting screen time before bed, and ensuring the child gets adequate physical activity during the day. If sleep problems persist despite these measures, it's essential to consult with a pediatrician who can evaluate for underlying medical issues and provide appropriate guidance, as some sleep difficulties in toddlers are developmental and resolve with time and consistent sleep practices 1.
From the Research
Melatonin Use in 2-Year-Olds
- There are no specific guidelines concerning the use of melatonin in 2-year-olds, as most studies have focused on older children and adolescents 2, 3, 4, 5, 6.
- The available evidence suggests that melatonin can be safe and effective in treating sleep disorders in children, but the dosage and long-term effects are not well established 2, 3.
- Some studies have reported that melatonin can be beneficial for children with sleep disorders associated with neurological conditions, but more research is needed to confirm its efficacy and safety in this population 2, 4.
- The use of melatonin in healthy children is not well supported by evidence, and its use in this population should be approached with caution 6.
- The potential risks and side effects of melatonin use in children, including non-serious adverse events and potential effects on pubertal development, should be carefully considered 5.
Considerations for Melatonin Use in Young Children
- The dosage of melatonin for young children is not well established, and it is recommended that the dose be individualized based on the severity and type of sleep problem 2.
- The lack of regulation of melatonin supplements in some countries, including the United States, raises concerns about the safety and efficacy of these products for use in children 6.
- More research is needed to fully understand the effects of melatonin on young children and to establish clear guidelines for its use in this population 2, 3, 4, 5, 6.