September 26, 2023

Melatonin poisoning on the rise in children

Source – Ged Carroll, CC SA 2.0.

Researchers are drawing attention to a rise in poisonings in children involving the sleep aid melatonin that includes a big jump during the pandemic.

U.S. Poison Control Centers have seen a 530 percent rise in calls about children who had ingested large amounts of the sleep-aid supplement, amounting to about a six-fold increase from 10 years ago, according to the study.

Between 2012 and 2021, more than 260,000 cases of melatonin ingestion were reported, and of these, more than 27,000 children required treatment in a health care facility.

That includes more than 4,000 children who were hospitalized and nearly 290 kids who received care in an ICU. Five of the affected children were placed on mechanical ventilators for breathing support and two children under age 2 died.

Parents may think of melatonin as the equivalent of a vitamin and leave it on a nightstand, said Dr. Karima Lelak, an emergency physician at Children’s Hospital of Michigan and the lead author of the new research published Thursday by the CDC.

“But really it’s a medication that has the potential to cause harm, and should be put way in the medicine cabinet,” Lelak said.

Most of the calls are about young children who accidentally got into bottles of melatonin, some of which come in the form of gummies for kids.

What is melatonin?

Melatonin is a hormone produced in the brain that regulates the body’s 24-hour circadian rhythm and sleep-wake cycle, It has become a popular over-the-counter (OTC) sleep aid for both adults and children, with sales increasing 150 percent between 2016 and 2020, the authors said, according to Live Science.

In the U.S., melatonin is sold as a dietary supplement and is not regulated as a drug. This means the U.S. Food and Drug Administration doesn’t have as much oversight over the purity of ingredients or the accuracy of dosage claims.

This also means it’s possible that the concentration of melatonin in a product might not match what’s listed on the bottle, since the FDA doesn’t confirm the label’s accuracy. 

For example, A 2017 study in the Journal of Clinical Sleep Medicine found that, at least in Canada, the concentration of melatonin in a supplement often varied widely from what was listed, and Canada later banned OTC melatonin due to these quality control issues. 

However, similar quality control studies have not been conducted in the U.S., the study authors noted.

The largest year-to-year increase in overdoses took place between 2019 and 2020, when the rate of reporting jumped about 38 percent.

“Unintentional ingestions were the primary drivers of this increase,” the researchers wrote in the study. “This might be related to increased accessibility of melatonin during the pandemic, as children spent more time at home because of stay-at-home orders and school closures.” 

Bottom line? Because melatonin is a hormone, there’s some concern that long-term use might have some effect on children’s puberty-related hormones. Such effects have been noted in some animal studies, according to Boston Children’s Hospital.