The Use of Melatonin for Children
Chevon Midkiff
Front Range Community College
May 2, 2012

The Use of Melatonin for Children
My husband and I both have used melatonin as a natural sleep enhancer in the past, but it had never really crossed my mind to give it to my children if they were to have sleeping problems. When I first became interested in the subject of melatonin for children I was convinced it wasn’t safe based on a situation my friend had told me about. She knew a mother who supposedly has been giving her child melatonin for years just because it was easier to get him to sleep. Being a mother and a nursing student I was shocked by this because I was concerned with the long-term effects it might have on her child. After doing some research I found that in fact it could be beneficial for children, especially children who have certain medical conditions such as blindness, attention-deficit hyperactivity disorder (ADHD), or autism (Galewitz, 2009). Like most things in life, there are almost always two sides to a story, if not more. I believe if used correctly and for the right reasons, melatonin can be a beneficial supplement for children, especially those who have certain disabilities.
Explained in Anatomy and Physiology written by Elaine N. Marieb and Katja Hoehn (2010), melatonin, which is produced in the pineal gland, “is a powerful antioxidant and amine hormone derived from serotonin” (p. 620). It is very important because it controls our sleep and wake cycle, which is controlled by the changes in light. Melatonin has been produced as a supplement, which you can purchase at most any United States local drug or vitamin store. For instance, blind children do not have the ability to sense light and need assistance with melatonin production to regulate their sleep (Galewitz, 2008). This could be an example of necessary supplementation. Also, melatonin may be partially responsible for the timing of puberty in children and therefore it is necessary to have it in their system (Marieb & Hoehn, 2010).
Another reason I believe melatonin can be a beneficial supplement is because it is a more natural method than using over the counter or prescribed western medicine. Melatonin is believed to be safe and non-habit forming, as stated on the label of one of the 100% natural sleeping aid products I have used containing melatonin. I believe the use of melatonin would be put into the “Natural Products” category as explained in “What is Complimentary Alternative Medicine?” published by the National Center for Complementary and Alternative Medicine (p. 2). Although melatonin is a hormone and not a dietary supplement or probiotic I believe it would be best suited under this category because it is technically natural. Also, “The 2007 NHIS found that 17.7 percent of American adults had used a nonvitamin/nonmineral natural product. These products were the most popular form of CAM among both adults and children” (NCCAM, 2008).
In addition to the other benefits melatonin has, it has also been known to positively help children with disabilities. In fact, many studies have been done, most with children who have disabilities, which have had positive results. It seems from most the research I could find the benefits outweigh any long-term side effects (if any at all found) for these children (Edmunds, 2003). In a study done by the Journal of Pineal Research by Hoebert, et al. (2009) with children who suffer from ADHD and chronic sleep onset insomnia (CSOI) it was concluded that the use of melatonin was an “effective therapy on the long term for the treatment of CSOI in children with ADHD and has no safety concerns regarding serious adverse events of treatment related co-morbidity” (p. 1). Hoebert , et al. (2009) showed even if melatonin had been given for years, if stopped, the child would again develop insomnia again; also, the “improvement of behavior and mood was reported in 71% and 61% respectively” (p. 1). In another study from Child and Adolescent Mental Health written by Seema Banta, “Parents (12) who participated in the survey noticed an improvement in sleep pattern and none reported any serious side-effects” (p. 1). According to these surveys, the positive results outweigh any negative ones.
For anyone who was reluctant about giving melatonin to children, Laurie Scudder, MS, RN-C, PNP, address a potential valid argument that “Melatonin is one of only two hormones whose sale is not regulated by the US Food and Drug Administration” (Edmunds, 2003). This is not necessarily a good reason to not believe melatonin could be used as a safe and effective supplement. Many drugs that are regulated by the US Food and Drug Administration have caused overdoses in children. Jackie Avner from the Denver Post explained, “In the U.S., there are [sic] more overdoses and deaths caused by acetaminophen than any other pharmaceutical agent, according to the national Poison Control Centers” (p. 2). Acetaminophen is a very commonly used pain reliever parents give their children. I know I have used it many times over the years but know I need to be careful about my youngest getting a hold of it, she would be tempted to drink it all. As stated in an article from the U.S. Department of Health and Human Services (2008), since melatonin, like all CAM products, is not regulated the same as over the counter (OTC) drugs, “a manufacturer does not have to prove the safety and effectiveness of a dietary supplement before it is marketed” (p. 6). Again, being proven safe doesn’t always mean it can’t be harmful. I believe under any circumstance it is still in the parents’ best interest to do as much research and talk to as many professionals prior to giving melatonin as a supplement or giving any over the counter medications to their child. It is ultimately up to the parent/caregiver to do what is best for their child. According to Galewitz’s (2008) article, Marcia Buck, a clinical pharmacy specialist at the University of Virginia Children’s Hospital in Charlottesville, states “This is not a treatment for the healthy child who just doesn’t want to go to bed or the child with occasional trouble falling asleep” (p 2.). Also in Galewitz’s article, Zafarlotfi, clinical director of the Institute for Sleep-Wake Disorders at Hackensack University Medical Center in New Jersey, “say occasional use of melatonin for children is fine as long as the dosage does not exceed 3 milligrams” (p. 1). Every individual is unique in his or her situation and understanding the risks and appropriate dosage to be given is always best. Just like it is important to make sure the proper dosage is given to your child for any OTC drug, the same applies to supplements such as melatonin.
Quality sleep is extremely important in maintaining a happy and healthy life. Children require a certain amount of sleep to be able to function correctly. As a parent, we are required to do what is best for our children, and we too should get an adequate amount of sleep to be the best parents we can be. If our child is not sleeping, most likely, either are we. I remember when my daughter had colic when she was only a few weeks old and I was incredibly sleep deprived. I can’t imagine what a child might feel if they aren’t getting enough sleep. For a parent whose child was blind or had another disability that affected their sleep, this would be extremely difficult to deal with on an everyday basis. If we are able to help our child and allow them to get the sleep they require by giving them a proven safe supplement, I believe the benefits outweigh any of the known side effects. A parent who has a child that suffers from conditions in which melatonin can help them will recognize the benefits melatonin has to offer to obtain a safe and effective treatment. In turn, this enables the child and parent to live a happier, healthy life, which is ultimately the main goal.

References
Avner, J. (2007, August 26). Acetaminophen overdose in children more common than you think. The Denver Post. Retrieved April 29, 2012, from http://www.denverpost.com/recommended/ci_6702756#ixzz1tT2mJic7
Banta, S. (2008, May). Use of melatonin in children and adolescents: clinicians' and parents' perspective [Electronic version]. Child and Adolescent Mental Health, 13(2008), 82-84. doi: 10.1111/j.1475-3588.2007.00459.x
Galewitz, P. (2008, March 2). Kids tucked in with a dose of melatonin. USA
Today. Retrieved April 17, 2012, from http://www.usatoday.com/news/health/2008-03-02-kids-melatonin_N.htm
Hoebert, M., Van Der Heijden, K. B., Van Geijlswijk, I. M., & Smits, M. G. (2009, March 25). Long-term follow-up of melatonin treatment in children with ADHD and chronic sleep onset insomnia. Journal of Pineal Research, 47(1), 1-7. doi: 10.1111/j.1600-079X.2009.00681.x
Marieb, E. N., & Hoehn, K. (2010). Human Anatomy & Physiology (eight ed., p. 620). San Francisco, CO: Pearson Education, Inc. Scudder, L. (2003, February 5). Is melatonin safe for children? In Medscape. Retrieved April 20, 2012, from http://www.medscape.com/viewarticle/448467
What is complementary and alternative medicine? (2008, October). In National Center for Complementary Medicine (NCCAM). Retrieved April 24, 2012, from http://nccam.nih.gov/health/whatiscam

Outline
Audience: A parent or caregiver who is considering giving their child melatonin.
Thesis:
I believe if used correctly and for the right reasons, melatonin can be a beneficial supplement for children, especially those who have certain disabilities.
Counterargument:
A parent that might argue it is not safe because the FDA does not regulate it, but this doesn’t necessarily make it unsafe.
Reasons:
-Because melatonin is important in regulating normal sleeping patterns for humans.
-Because I believe melatonin can be a beneficial complimentary alternative medicine (CAM) because it is a more natural method then using over the counter or prescribed conventional medicine.
-Because there have been many studies done, most with children who have disabilities, that have had only positive results from being given melatonin.
-Because controls our sleep and wake cycle which is controlled by the changes in light and some children are not able to produce melatonin because of blindness or other disabilities.