Acknowledging the increasing popularity of kids taking melatonin supplements, an International Pediatric Sleep Association (IPSA) task force has provided real-world recommendations for the use of the medication available over-the-counter in the United States, in typically-developing children.
The consensus recommendations for healthcare providers and the guide for patients both emphasize that melatonin should be used only with the recommendation of and supervision from a medical provider, after a thorough clinical sleep evaluation, that behavioral approaches should both precede and accompany any recommendations to use melatonin, and should not be used for sleep disorders other than chronic insomnia disorder and circadian rhythm sleep-wake disorders. “Melatonin is not indicated for other sleep disorder such as sleepwalking and restless sleep,” the authors state in the published paper.
Melatonin Dosing in Children
The melatonin task force recommendations starting at the lowest possible dose (0.5 mg) and titrating up to the maximum, based on the child’s age, only if needed. Dose increases, by 0.5 mg at a time, should only happen once a week.
The dosing recommendations published in the IPSA paper are:
- Infants (0–2 years): Not recommended
- Toddler (2–3 years): Up to 1 mg
- Preschool (4–5 years): Up to 2 mg
- School-Age (6–10 years): Up to 3 mg
- Older School-Age/Adolescents: Up to 5 mg
The dose should be taken 30 to 60 minutes before the child’s bedtime, and children should not take middle-of-the-night doses.
An accompanying technical report provides more detail for healthcare professionals.
Sleep specialists may also find an earlier assessment from the IPSA about melatonin use in children with autism helpful.
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