Image Credit: nodar77/EnvatoElements.com
By Kim Ross, DCN, CNS, IFMCP
Reviewed by Deanna Minich, Ph.D.
October 24, 2023
The use of melatonin for children and teens has been in the news a lot. This is primarily the result of a recent report from the Centers for Disease Control and Prevention that found that the number of calls for childhood ingestion of melatonin has increased by 530% from 2012-2021. While many of these were unintended ingestions, it raises the issue of whether children and teens should be using melatonin at all.
If kids aren’t sleeping, what should you do?
Children and teens produce much more melatonin than adults, up to 5 times as much in their teens than 50-year-olds. As a result, it is unlikely that a lack or insufficiency of melatonin is the reason for sleep issues in younger people under the age of 18.
There appears to be a consensus among healthcare providers and medical organizations that supporting better sleep habits and sleep hygiene is the preferred and ideal first-line approach that somebody should consider for most children, teens, and their families.
Darkness deficiency and light excess might be the biggest enemies to supporting quality sleep. Take a moment to look around your present environment---you will likely notice an overabundance of light in your life – phones, computers, TV, alarm clocks, nightlights, and lights on at all hours. This excessive light inhibits melatonin from being produced due to the lack of darkness.
For more information and ideas about sleep issues in children and teens, read our blog post: Should Children and Teens Be Taking Melatonin Supplements?
Everything now comes as gummies. Is this a good thing?
There is a growing trend in the consumption of gummy supplements, including melatonin gummies, which has sparked concerns about their safety and efficacy. While there are several ways to consume melatonin, taking it orally is the only format available in the U.S. as a dietary supplement [1].
The transition to gummies has been historic.
In 2018, it was reported that 48% of all melatonin products were in capsule form, 22% in tablets, 14% in powders, 11% in liquids, and 5% in all other forms (including gummies at 0.8%) [2]. Now 48.4% of all melatonin products sold on Amazon are gummies, 36.3% in flavored chewable, and 15.4% in other formats [B. Sample, email communication, October 5, 2022]. From less than 1% of the market taken as gummies to nearly 50% in a handful of years!
We get it, gummies are easy to take and tasty. But each one may contain as much as a cube of sugar.
This article will discuss some concerns about melatonin gummies.
Concern #1 - Gummies look and taste like candy—and so does the packaging.
Parents want the process of taking supplements to be hassle-free with their children. So, it’s not surprising that 70% of multivitamin-mineral supplements are in gummy form for the pediatric population, followed by chewable tablets at 29% [3]. Approximately 65% of gummy-formulated supplements are marketed toward children [4]. Clearly, a gummy or chewable form of melatonin (or any other supplement) would be easy for children to consume compared to swallowing a capsule or tablet. It is also visually appealing to children and can be pleasing to eat because gummies look and taste like candy. This is exactly why parents should avoid calling melatonin “candy” or “vitamins” to get children to take it, as doing so can lead to potential misuse or overuse of the supplement [5]. Gummies can also promote the use of melatonin supplementation when it may not be needed. Children naturally produce higher amounts of melatonin to promote more sleep, making its application for children limited to certain conditions such as ADHD or autism [1].
A search on Amazon for melatonin supplements for kids revealed that 76 products were available, with most containing imagery or wording appealing to children. The packaging usually uses primary colors that are often associated with kid-friendly items, images including cartoon-like animals such as sheep and teddy bears, and wording such as “nighty-night.” Additionally, melatonin supplements are not packaged to be child-proof.
This point brings us to another concern about melatonin gummies: the potential overdose or misuse of melatonin, especially by children.
Concern #2 - Overdose or misuse in children.
Nearly 25% of the calls to a poison control center were for gummy melatonin.
The CDC has reported that from 2012-2021, a total of 260,435 reports of pediatric melatonin ingestion were reported nationally to poison control centers---most of them were unintentional (94.3%). While most children were asymptomatic (84.4%), the remaining 15.6% were symptomatic, which included gastrointestinal, cardiovascular, or nervous system symptoms [6]. Some common symptoms include headaches, feeling groggy, also sometimes called a “melatonin hangover,” or severe sedation.
In 2021, a retrospective study [4], including children ages 0-19, was conducted over three years to examine exposure specifically to gummy-formulated medications as identified by calls made to the Regional Poison Control Center in Alabama. The medication list was classified into four categories: vitamins, minerals and supplements, melatonin, and others. This study reported the following:
- 24.1% of the calls were in response to the ingestion of gummy melatonin.
- Children had 8.4 times higher odds of being symptomatic when gummy melatonin was ingested (this finding was statistically significant).
- Children had 4.8 times higher odds of visiting an emergency room when gummy melatonin was ingested (this finding was statistically significant).
Why are children unintentionally ingesting melatonin? This question brings us to the next challenge.
Concern #3 - Added sugars/sweeteners—each gummy may contain a teaspoon of sugar.
Most people don’t realize the immense quantity of sugar the average person ingests daily. Estimates from the Centers for Disease Control and Prevention (CDC) indicate that the average American (adults and children 2 years and older) consumes 17 teaspoons of sugar each day.
This amount includes hidden sources of sugar, such as condiments and dressings, packaged foods, such as cereals or cereal bars, and certain forms of supplements, such as gummies. The American Heart Association suggests limiting sugar intake to less than 6 teaspoons per day for women and children and less than 9 teaspoons for men. Whereas the Dietary Guidelines for Americans, 2020-2025, the CDC recommends limiting sugar to less than 10% of daily caloric intake. (With an intake of 2,000 calories per day, this would be less than 12 teaspoons per day.) Children under the age of 2 should not consume any added sugars.
Added sugars or sweeteners are used in gummies to make them tasty and especially appealing to children. While it is not the only ingredient used, sugar (including corn syrups and sucrose) can contribute to the “shiny” coat often found on gummies, while dextrose can be used to help control moisture retention and texture [7].
Sweeteners that may be included in gummy supplements can include, but are not limited to:
- artificial sweeteners (aspartame, saccharin, sucralose). If something is labeled “sugar-free,” check for these ingredients.
- cane juice
- sugar (Do not be misled by “organic sweeteners,” such as organic cane sugar. This is still sugar.)
- sugar alcohols (e.g., erythritol, maltitol, mannitol, xylitol)
- syrups, such as corn syrup, tapioca syrup, glucose syrup
Our independent review was conducted on 20 gummy melatonin supplements available for purchase on Amazon. The labels revealed that gummy melatonin supplements contain between 1-8 grams of sugar per serving. This amount is up to 2 teaspoons of sugar per serving, with the average being nearly 4 grams or one teaspoon of sugar per serving!
Hold this thought for a moment…On average
1 serving of a melatonin gummy = 4 grams of sugar =
1 teaspoon of sugar = 1 sugar cube
The cumulative intake of sugar by taking melatonin gummies could be:
- 7 teaspoons per week
- 30-31 teaspoons per month
- 365 teaspoons per year
Remember, you would double these estimates if the supplement chosen contained 8 grams of added sugar per serving!
Ironically, added sugar may defeat the reason for taking melatonin in the first place.
It is important to note that sugar alone can impair the quality of sleep. Studies in both children and adults suggest that consuming sugar can contribute to disrupted sleep throughout the night, waking up unrefreshed [8,9]. Additionally, consuming food, including sugar, 2-3 hours before bedtime can impair one’s ability to fall asleep. Neither children nor adults benefit from consuming sugar before sleep.
Concern #4 - Added fillers and excipients—can cause hyperactivity and neurobehavioral issues.
There are a number of fillers and excipients that can be used in the manufacturing of supplements. You will typically find these listed in the “other ingredients” on the label. This can include binding, gelling, and coating agents, preservatives, colors/dyes, flavors, and sweeteners. The addition of dyes, flavoring agents, and other excipients are needed for the texture, taste, and form of gummies. For example, dyes give the supplement its coloring, natural or artificial flavoring will provide the taste, and gelling agents provide texture and help to set the product quicker [7].
Gummies come in various colors and flavors, with blended fruit flavors holding popularity with kids and adults alike. However, these colors and flavors must come from somewhere. Currently, there are seven Foods, Drug & Cosmetic dyes approved for use in foods and supplements, resulting in the colors “Tartrazine,” Allura Red,” “Indigo Carmine,” “Brilliant Blue,” “Fast Green,” “Erythrosine” and “Sunset Yellow” [10]. A report from the state of California, released in April 2021, confirmed that “synthetic food dyes can cause hyperactivity and other neurobehavioral issues for some children” [11].
Flavoring agents are used to provide the taste one might expect from the color of the gummy, and these may be derived from artificial or natural sources.
Gelatin is an animal-based excipient that is used in gummy formulas to give it the classic chewy, elastic-like texture. Vegetarians and vegans will want to be mindful of this ingredient since it is animal-based. The bigger concern is that the gelatin will make the supplement more susceptible to melting when exposed to heat [7]. The melting of the gummy can result in unexpected melatonin levels in what is left of the gummy after it has melted. This can be especially concerning for children, and adults alike, as the label claim for the dose can then be altered, causing potential toxicity or overdose concerns. It is worth noting that sugar-free formulas will use more gelatin than their sugar-containing counterparts [7].
Additionally, if the gummy supplement is in a sustained or extended-release format, they may utilize a variety of non-desirable, toxic coating agents, such as phthalates, to slow absorption [12]. This is noteworthy, as phthalates are known endocrine disruptors, which is a compound that can interfere with the body’s hormones. As a reminder, melatonin is a hormone.
Concern #5 - Quality—a study showed content ranged from 17% to 478% of listed label dose.
As with all supplements, choosing a supplement company that adheres to good manufacturing practices (GMPs) will help ensure you choose a supplement that abides by strict quality assurance guidelines. Melatonin is no exception.
Multiple studies have reported on various quality issues, from potency, to label claims, to the presence of adulterants and contaminants. For example, presently, 99% of supplemental melatonin is synthetic, derived from chemical synthesis, often involving petrochemicals, with the potential for dosing, quality, and adulteration issues (up to 13 different contaminants) [1]. An analysis of 31 melatonin supplements reported that the melatonin content ranged from 17% to 478% of what was listed on the label, with a lot-to-lot variability of up to 465% [13]. This not only brings concerns about label claims but raises concerns about possible toxicity or overdosing, especially in the pediatric population.
Testing was conducted by ConsumerLab.com on many forms of gummy supplements and found that some had much higher or lower amounts of the ingredients listed on the label, raising quality concerns.
Melatonin can also degrade in the presence of light and air, making oxygen-barrier blister packs an ideal packaging option over an open bottle format. Further, melatonin may react with moisture. The gummy hygroscopic matrix (high in water content) may make this format of melatonin more susceptible to oxidation, raising additional delivery and quality concerns [1].
Consumerlab.com has also independently and anonymously tested melatonin supplements for over a decade verifying if products are compliant with label claims and testing the amount of melatonin in the product matches the label, and that heavy metal levels are within Prop 65 and California’s limits. Not only has Herbatonin passed with flying colors for the last 13 years, but it is now one of Consumerlab’s TOP PICKS. But our quality and purity don’t stop there, as opposed to synthetic melatonin products and gummies, Herbatonin does not include any excipients, binders, solvents, petrochemicals, gelling or coating agents, preservatives, colors, dyes, flavors, sweeteners, or allergens such as gluten, yeast, wheat, corn, dairy or soy.
Is it ever appropriate for children and teens to take melatonin?
There are some cases where melatonin may benefit younger people. Melatonin has been studied extensively in children with Attention Deficit Disorder (ADD), Attention Deficit and Hyperactivity Disorder (ADHD), as well as with children with Autism Spectrum Disorders (ASD). These groups have been shown to have decreased melatonin production and are known to have many circadian rhythm and sleep disorders that likely contribute to daytime behavioral symptoms [14-16].
Most studies focus on short-term, low-dose use for pediatrics with these medical conditions, with a maximum dose of 3 mg for children and 5 mg for adolescents [17].
Another consideration would be jet lag. Just like adults, the circadian rhythm of kids will need to adjust when traveling across one or more time zones. Presently, studies are lacking on this specific topic for children, though melatonin’s use for jet lag is commonly known, utilized, and well-studied and therefore you may see blogs, social posts, or online recommendations from pediatricians and parents alike. While the recommendations include a variation of doses, Symphony Natural Health suggests using a lighter dose in children than would be used in adults- Herbatonin 0.3 mg. Don’t forget to get the clearance from your child’s pediatrician first!
Conclusion—Our goal is for you to be an informed consumer.
As you can see, several concerns arise when using gummy melatonin, including the sugar and sweeteners used, the added dyes, flavoring, or other excipients, and the overall quality of most melatonin supplements. If melatonin is needed, aim for a high-quality phytomelatonin that is non-toxic, and free of sugars/sweeteners, dyes, flavoring agents, and excipients.
For those who choose gummy melatonin because of difficulty swallowing capsules, choose a high-quality phytomelatonin that is delivered in a small, vegan capsule.
- It is smaller, making it easy to swallow for most.
- It can be opened and sprinkled on food, such as plain yogurt, or unsweetened applesauce, or added to a nutrient-rich smoothie.
References
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2. Saldanha LG, Dwyer JT, Bailen RA, et al. Characteristics and challenges of dietary supplement databases derived from label information. J Nutr. 2018. doi:10.1093/jn/nxy103
3. Ethan D, Basch CH, Samuel L, Quinn C, Dunne S. An Examination of Product Packaging Marketing Strategies Used to Promote Pediatric Multivitamins. J Community Health. 2015. doi:10.1007/s10900-014-9972-1
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8. Shih YH, Wu HC, Pan WH, Chang HY. The Association Between Frequent Sugar-Sweetened Beverage Intake and Sleep Duration in School Children: A Cross-Sectional Study. Front Nutr. 2022;9(March):1-11. doi:10.3389/fnut.2022.847704
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11. New report shows artificial food coloring causes hyperactivity in some kids. Berkeley Public Health.
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