Pediatricians at Kaiser Permanente urge caution using melatonin for children


Dr. Kirsten Reinecke, pediatric sleep specialist with Kaiser Permanente Northwest, talks about melatonin usage all day with the majority of her patients in the Portland Metro area.

A recent report from the U.S. Centers for Disease Control and Prevention revealed a rise in childhood emergency room visits related to melatonin ingestion while unsupervised — nearly 5,000 cases involving melatonin gummies alone. Most incidents involve children between 3 and 5 years old, indicating the need for enhanced safety measures, a press release by Kaiser Permanente Northwest stated.

“Melatonin is a hormone produced in our brain to help regulate our sleep-wake cycles,” Reinecke told the Reflector. “The presence of light tells your brain to not make melatonin and once the light goes away, your brain will start to make melatonin.”

She said the best method to help a child, or anyone for that matter, sleep is to create a bedtime routine and a quiet and dark sleep environment. The dark sleep environment, Reinecke said, is a necessary factor in the routine.

“The absence of light is what will help to optimize your own internal production of melatonin,” she said.

Reinecke recommends using melatonin supplements with children when a change of environment occurs, such as while staying at a hotel, during travel and a change in time zones. Reinecke encourages families to consult their pediatricians ahead of giving or taking melatonin supplements to learn about proper dosing as it should be treated with the same respect that all medications are, especially with children, she said.

With the recent uptick in childhood emergency room visits due to melatonin, the Council for Responsible Nutrition (CRN) has called for voluntary action within the industry to enhance packaging and labeling standards for melatonin products.

“The CRN has put out recommendations for melatonin manufacturers to have more responsible packaging for melatonin, and I, along with Kaiser Permanente, really support child-resistant packaging, such as the caps or labels that are not attractive to children,” Reinecke said. “Melatonin is often produced as colorful fruit-flavored gummies, and that’s appealing to children. One of the phenomena that we have observed is a 530% increase in poison center calls for pediatric melatonin exposures over the past decade — and most of those are in children under age 5, primarily unobserved intake of melatonin.”

Reinecke believes melatonin is a “tool in the toolkit” to help one’s child sleep better, but the medication needs to be kept out of a child’s reach along with better packaging.