Calls to Poison Control About Children Taking Too Much Melatonin Have Risen Dramatically in the Last Decade

The number of calls to Poison Control about children that involve the sleep aid melatonin has risen dramatically in the last decade, with an especially large jump in cases during the pandemic. Last year alone, the U.S. poison control centers received 52,563 calls about children consuming worrisome amounts of the melatonin, according to a new report release on June 2 by the Centers for Disease Control and Prevention (CDC).

Melatonin is a hormone produced by the brain in response to darkness; it helps with the timing of circadian rhythms, the body’s natural sleep-wake cycle. Most melatonin dietary supplements are made synthetically (from chemicals rather than derived from humans or animals), according to the Sleep Foundation.

According to the foundation, there is no official recommended melatonin dose for adults or children, but the “safe and effective” range is between 0.5 to 5 milligrams. To date, there is no definite amount that constitutes a melatonin overdose, according to Poison Control.

“Although this report relies on call-in data from patients rather than hospital records, I do believe the overall findings are credible and alarming,” says Naima Covassin, PhD, assistant professor at Mayo Clinic in Rochester, Minnesota, who was not part of this research. “While most of these reported ingestions caused no symptoms or mild symptoms, a number of incidents were more serious events that required hospitalization or even death,” said Dr. Covassin.

Earlier this year, Covassin was the lead author of a study published in JAMA that found melatonin use has grown by more than 500 percent in the last two decades, from 0.4 percent in 1999–2000 to 2.1 percent in 2017–2018. Given this overall increase in usage, it makes sense that this would result in a parallel rise of children consuming a worrisome amount of the supplement, she says.

Calls About Children Consuming Too Much Melatonin Accounted for 5 Percent of All Poison Control Calls in 2021

Between the years 2012 to 2021, there were a total of 260,435 calls about kids taking too much melatonin. These calls accounted for 0.6 percent of all poison control calls in 2012 and nearly 5 percent by 2021— a sixfold increase

In about 5 out of 6 cases, the affected children did not show any symptoms. For those who did exhibit indications of overconsuming melatonin, vomiting and altered breathing were among the symptoms reported.

Over the 10-year period, 27,795 sought medical treatment, 4,097 kids were hospitalized, 5 needed to be put on machines to help them breathe, and 2 children — both under 2 years old — died.

The Largest Increase in Pediatric Melatonin Consumption Ingestion Occurred During First Year of Pandemic

The biggest jump in pediatric melatonin ingestions happened after the COVID-19 pandemic began in 2020; between 2019 and 2020, the number calls of increased by 37.9 percent. There was also an increase the number of hospitalizations caused by melatonin overdose — most of the hospitalized children were teenagers, and many of those were believed to be suicide attempts.

The largest percentage increase in hospitalization occurred in children 5 years old or younger, and those were due to unintentional ingestions.

This study wasn’t designed to investigate the reasons why the onset of the pandemic coincided with the biggest increases in melatonin ingestion in children — more research is needed, says lead author Karima Lelak, MD, pediatrician at the Children’s Hospital of Michigan in Detroit. “We suspect that the increase during the pandemic may be a due to a combination of increased use of melatonin or more melatonin in the home, and more children being home due to pandemic related restrictions,” she says. According to the report, 99 percent of worrisome melatonin consumption in children occurred in the home.

The authors acknowledge some limitations to the study, including the fact that poison control center data relies on passive, voluntary and self-reported incidents that aren’t confirmed by hospital records.

Melatonin Supplements Can Vary Widely From the Labeled Content

“In the European Union, you need a prescription to get melatonin and therefore it’s highly regulated,” says David Neubauer, MD, associate professor of psychiatry and behavioral sciences and sleep expert at Johns Hopkins Medicine in Baltimore. Because melatonin is sold as a dietary supplement in the United States, it’s not subject to the same rules as prescription drugs or over the counter medications, he says.

“There have been studies showing that the content of melatonin in supplements doesn’t always match what’s listed on the packaging. That means that it’s possible that a person could accidentally overconsume melatonin even if they followed the instructions on dosing included on the label,” says Covassin.

A study published in 2017 in the Journal of Clinical Sleep Medicine found that melatonin content in supplements ranged from 83 percent less to 478 percent more than the labeled content. Many of the melatonin supplements studied also contained serotonin, a hormone that can have harmful effects, even at relatively low levels, according to the National Center for Complementary and Integrative Health.

According to the authors of the current study, the highest variations in melatonin content was found in the chewable “gummy” formulations, which are also the most likely to be used by children. “This is also the formulation that would most likely be accidentally consumed by children who might mistake it for candy,” says Covassin.

Keep Melatonin Safely Stored Away From Children

Melatonin appears to be safe for short-term use, though more data is needed to know the long-term health effects of taking melatonin, according to Complementary and Integrative Health, a branch of the National Health Institute.

Here’s what you should know if you are thinking of using the supplement for yourself or your child, according to the agency:

• Consult with your doctor before using melatonin or giving it to your children. The supplement may interfere with other drugs, and there is also a risk of an allergic reaction.
• If you’re pregnant, be aware that there’s a lack of research regarding the safety of melatonin in pregnant and breastfeeding women.
• Melatonin should not be used by older adults with dementia, and it may cause daytime drowsiness in older people.
• Although the supplement appears to be safe in children, there have been side effects reported, which include drowsiness, increased bedwetting or urination in the evening, headache, dizziness, and agitation.

Melatonin should always be stored safely and out of reach of children, says Dr. Lelak.