Jet lag with kids is miserable, so it is unsurprising that the popularity of melatonin, an over-the-counter remedy for sleep disorders including jet lag, has soared in recent years.
But is it safe, or effective? As a semi-regular flyer from the USA to Europe myself, I asked health professionals and parents what they thought about giving melatonin to kids with jet lag.
What is melatonin?
Melatonin is one of the hormones we produce that regulates our circadian cycle, which is how our body knows when it is time to sleep and wake up. Shift work, medical conditions, too much screen time late at night, and of course changing time zones, can mess up our body’s rhythms.
Melatonin does not make us go to sleep but it does send a signal to the body that it is time to prepare for sleep.
There have been studies suggesting melatonin supplements can be useful for people who cannot make enough themselves and are having difficulties getting to sleep.
In the US, melatonin is considered a supplement and is available over the counter in drug stores and groceries. It is the second most popular supplement for children, next to fish oil in terms of sales. The global market is set to double by the end of 2019, with the most sales coming from the US.
And a 2002 study showed that in nine out of 10 clinical trials, melatonin helped travelers overcome jet lag when crossing five or more time zones.
Can you use melatonin for kids and toddlers with jet lag?
While there is quite a lot of research into adults using melatonin, there are fewer studies in children, with the exception of children with autism.
Yet pharmacy shelves are full of bottles promoting melatonin as a safe and natural sleep aid for children. In the US, melatonin is not regulated as a drug by the US Food and Drug Administration (FDA) and is easily available over the counter. In the EU, Canada and Australia melatonin is available on prescription only.
Does melatonin work for kids and toddlers with jet lag?
With little clinical research available, I asked frequent flying families who have used melatonin what they thought.
“I’m a huge fan,” said one parent. “The kids used a much smaller dose but it worked well.”
“It has been a game changer for our daughter, who always struggled to fall asleep. Now, she is asleep within minutes,” said another.
However, others I spoke to cautioned about the effects of melatonin.
“We tried it with our 19-month-old as a trial before our trip to Europe next month. We were one of the wonderful cases where it was an adverse reaction. The kid was WIRED and didn’t fall asleep until four.
“It was brutal but we are so glad we tried at home before testing it on our trip.”
Others reported restless leg and nightmares as a result of taking the supplement, while one parent who had taken it herself as an antidote to jet lag told me her periods had stopped for two months.
Is melatonin safe for kids?
I asked Mar De Carlo, founder of the International Maternity and Parenting Institute and children’s sleep coach what she thought about some of these side effects.
She said she was not surprised. “Melatonin is a hormone that is not regulated by the FDA. There has been research to suggest it can affect puberty, but we don’t have enough information about the long-term effects.”
Ms De Carlo explained, “When you start changing one thing in your body there is a domino effect. There are so many factors that affect sleep, like light, food and stress. Society likes to turn to a magic pill but nature doesn’t work that way.
“There are cases where you would need melatonin but the average child does not need melatonin. If you are going through travel time changes there are other things we can do to prepare.”
Dr Michael Breus, who is a Diplomate of the American Board of Sleep Medicine, agreed.
“I do not recommend melatonin in anyone under the age of 18,” he told me.
“Except in kids who are on the Autism Spectrum, in which case we look at 3-5 mg. Melatonin is a hormone and at higher doses it is a contraceptive. I can’t think of a reason why I would introduce a contraceptive into a young female developing body, without a gynecological concern.
“Most kids have plenty of melatonin in their systems, so supplement is simply not needed.
“I also COMPLETELY disagree about giving ‘sleep aids’ to kids. In some rare cases it may make sense (for very long flights) but you can actually do everything you need for a child, with light, exercise, caffeine and napping.”
I did find one sleep doctor who had reviewed the available research and felt melatonin is a safe supplement, when used appropriately, such as for children with autism, or short term, usually less than two weeks, when children are having short-term insomnia.
Sleep medicine specialist and American Academy of Sleep Medicine member Dr Shalini Paruthi said she would have no problem recommending melatonin for short-term use.
“The largest study [of melatonin in kids] followed 100 kids over three and a half years and that study did not report any major side effects. And they were pre-pubescent grade school kids. I think it can be safe,” she explained.
For parents who want to try giving kids melatonin, she recommends using it in conjunction with other jet-lag busting techniques.
“Westwards, they won’t need melatonin – just get them to bed a bit later every night,” she said.
Dr Paruthi said traveling eastwards is much harder and you can expect to take a day to adjust for every time zone you cross.
“If you do want to try it, try it at home first for three nights. Because for some kids it has the reverse effect, it makes them hyper,” Dr Paruthi warned.
“Give it to them an hour before bedtime and make sure they get bright light in the morning because that is the most important thing to reset the circadian system – more than the melatonin,” she added.
What is a safe melatonin dosage for kids?
Children only require small doses, Dr Paruthi said – parents should start at 1mg and move up to 2mg only if there are no ill-effects.
Dr Paruthi recommended following the instructions on the bottle for dosage, which also tell parents not to give melatonin to under three-year-olds. Jet lag is actually less of a problem for babies anyway, as they take regular naps throughout the day.
The 2002 study on jet lag and melatonin found the optimum dosage for adults was just 2mg and doses larger than 5mg did not make any difference.
However, even if you feel confident enough in the safety and efficacy of melatonin as a jet lag remedy in children, there is another problem.
A study published in the Journal of Clinical Sleep Medicine in 2017 found a worrying discrepancy between the melatonin content advertised and the actual dosage in the bottle in over-the-counter supplements.
The authors analyzed the contents of 31 different brands of over-the-counter melatonin supplements in Canada, before it was made available by prescription-only in that country.
Shockingly, they found melatonin content varied from -83% to +478% of the label. The authors found that the worst culprits were the chewable tablets, which are most likely to be used by children.
It contained almost 9mg of melatonin when it was supposed to contain 1.5mg, the authors found.
The study found there were huge variations even between the same brands, so you could be getting a completely different product each time you buy a bottle – even if you stick to the same brand.
With such massive differences, it is easy to see how someone could take 10 times the recommended dose accidentally.
Alternatives to melatonin for jet lag
All of the health professionals I spoke to agreed on one thing: the most important thing you can do to adjust to a new time zone is to get outdoors, as much as possible.
Here are the seven things you can do to beat jet lag:
1. Get outdoors
Sunshine is the most important factor in resetting your internal clock.
2. Eat at regular mealtimes
Even if you’re not particularly hungry, it will help your body understand it is lunchtime if you eat at noon. Avoid eating outside regular mealtimes.
3. Drink water
If you are hungry, try drinking water instead. Drink plenty of water during and after the flight, make sure everyone has a full water bottle before boarding.
4. Avoid “exciting” food
Caffeine, too much sugar or even spicy foods on the flight or the first day are not your friend. Keep meals easy to digest to help your body relax.
5. Time-shift before you travel
Help your children adjust to a new time zone by slowly changing their bedtime and wake up time a few days before you travel, giving them a head start on adjusting to the new schedule.
6. Don’t stress out
Expect some tiredness and embrace it. Don’t plan a full-on day of activities the second you land. Give yourself time to relax, unwind and recover from travel on that first day.
7. Naps are OK
Build nap times into your itinerary. Let kids take a nap in the afternoon and stay up later for an evening meal, rather than force them to stay awake all day and tantrum during the appetizers.
For more tips on stress-free travel with children, take a look at my posts on flying with a baby and flying with a toddler.
If you do want to try melatonin for yourself or your family, it wouldn’t hurt to speak to your doctor first. Here are some tips for giving melatonin to kids:
1.Try it at home first
2.Start at 1mg, for under 18-year-olds, try 2mg for adults
3.Take a tablet an hour before bed time
4.Stop if there are side-effects
5.Only use it for the first two or three nights and only eastwards
6.Combine melatonin with other jet-lag beating techniques
7.If you are taking ANY medication at all, consult a doctor before using as melatonin is known to interact with some drugs (birth control included).
After speaking to the health professionals, families who have tried it and especially after reading the Journal of Sleep Medicine paper, I have decided I will not be using melatonin on our next trip. I will be using all the tips they gave me on shifting my sleep schedule without supplements, however.
What are your thoughts on melatonin? Have you tried it yourself? Do you think it could be better controlled or are you happy to have it easily available? Let me know in the comments!
I never would have thought of melatonin as a way to conquer jet lag. very interesting!
I had never heard of using this for jet lag. I’m not too much of a medicine taker, but I can see how esp if there is a drastic time shift, this might be a good option to bust out!