Melatonin Supplements for Kids
1. Safety & Efficacy of Melatonin Use in Small Children
DesignThis review article covers key studies on the use of melatonin in pediatrics, including its use for children’s sleep disorders, pediatric anesthesia, epilepsy and febrile seizures, adolescent idiopathic scoliosis, neonatal care, and the feeding of newborns.Key FindingsMelatonin use in children has been well-studied to date, and research suggests efficacy for several conditions. Melatonin has been most studied for its chronobiotic (sleep modulation) effects in various pediatric populations. Experimental models have also demonstrated usefulness as an antioxidant. Inconsistent benefit has been found in studies on its analgesic/anxiolytic use in pediatric populations. No significant side effects of melatonin use in children have been reported.Practice ImplicationsThis review article provides very interesting information in support of melatonin’s use for several pediatric conditions.Most interesting is the use of melatonin in children’s insomnia, a condition for which there are no approved pharmaceutical drugs. Most pediatricians and primary care physicians rely on behavioral treatments for insomnia, but a growing number of physicians are recommending melatonin, based on a 2003 survey in the journal Pediatrics.1 This review summarizes studies on general dyssomnias in addition to sleep disturbances associated with autism spectrum disorders (ASD), attention-deficit hyperactivity disorder (ADHD), and other mental or neurological disorders or disabilities. In general, these dyssomnias are associated with a difficult time initiating or maintaining sleep. Administration of melatonin has been associated with faster sleep onset, as well as increased sleep duration. The greatest effect is seen with advancing sleep onset, and the most benefit is achieved when melatonin is dosed approximately 30–60 minutes before desired bedtime. Doses used in the studies ranged from 0.5 to 9 mg, and positive effects were seen at all doses. The longest-term study evaluating melatonin use for insomnia was conducted in children with ADHD. This study surveyed parents whose children had been treated, on average, 3.7 years and demonstrated efficacy in 88% of cases and reported no serious adverse effects.
2. Clinical Uses of Melatonin in Pediatrics
This study analyzes the results of clinical trials of treatments with melatonin conducted in children, mostly focused on sleep disorders of different origin. Melatonin is beneficial not only in the treatment of dyssomnias, especially delayed sleep phase syndrome, but also on sleep disorders present in children with attention-deficit hyperactivity, autism spectrum disorders, and, in general, in all sleep disturbances associated with mental, neurologic, or other medical disorders. Sedative properties of melatonin have been used in diagnostic situations requiring sedation or as a premedicant in children undergoing anesthetic procedures. Epilepsy and febrile seizures are also susceptible to treatment with melatonin, alone or associated with conventional antiepileptic drugs. Melatonin has been also used to prevent the progression in some cases of adolescent idiopathic scoliosis. In newborns, and particularly those delivered preterm, melatonin has been used to reduce oxidative stress associated with sepsis, asphyxia, respiratory distress, or surgical stress. Finally, the administration of melatonin, melatonin analogues, or melatonin precursors to the infants through the breast-feeding, or by milk formula adapted for day and night, improves their nocturnal sleep. Side effects of melatonin treatments in children have not been reported. Although the above-described results are promising, specific studies to resolve the problem of dosage, formulations, and length of treatment are necessary.
3. Melatonin Treatment Effects on Adolescent Students’ Sleep Timing and Sleepiness in a Placebo-controlled Crossover Study
During the last few decades, the incidence of sleep-onset insomnia, due to delay of circadian phase, has increased substantially among adolescents all over the world. We wanted to investigate whether a small dose of melatonin given daily, administered in the afternoon, could advance the sleep timing in teenagers. Twenty-one students, aged 14-19 yrs, with sleep-onset difficulties during school weeks were recruited. The study was a randomized, double blind, placebo (PL)-controlled crossover trial, lasting 5 wks. During the first 6 d in wks 2 and 4, the students received either PL or melatonin (1 mg) capsules between 16:30 and 18:00 h. During the first 6 d of wk 5, all students received melatonin. Wks 1 and 3 were capsule-free. In the last evening of each week and the following morning, the students produced saliva samples at home for later melatonin analysis. The samples were produced the same time each week, as late as possible in the evening and as early as possible in the morning. Both the student and one parent received automatic mobile text messages 15 min before saliva sampling times and capsule intake at agreed times. Diaries with registration of presumed sleep, subjective sleepiness during the day (Karolinska Sleepiness Scale, KSS) and times for capsule intake and saliva samplings were completed each day. Primary analysis over 5 wks gave significant results for melatonin, sleep and KSS. Post hoc analysis showed that reported sleep-onset times were advanced after melatonin school weeks compared with PL school weeks (p < .005) and that sleep length was longer (p < .05). After the last melatonin school week, the students fell asleep 68 min earlier and slept 62 min longer each night compared with the baseline week. Morning melatonin values in saliva diminished compared with PL (p < .001) and evening values increased (p < .001), indicating a possible sleep phase advance. Compared with PL school weeks, the students reported less wake up (p < .05), less school daytime sleepiness (p < .05) and increased evening sleepiness (p < .005) during melatonin weeks. We conclude that a small dose of melatonin given daily, administered in the afternoon, could advance the sleep timing and make the students more alert during school days even if they continued their often irregular sleep habits during weekends.
4. Abstract on Long-term Effects of Melatonin Use for Children with ADHD
We conducted this study to assess long-term melatonin treatment course, effectiveness and safety in children with attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia (CSOI). This was conducted by means of a structured questionnaire for the parents. The subjects of this study consisted of participants who previously participated in a randomised clinical trial on melatonin efficacy. The response rate was 93% (94/101). The mean time to follow up was 3.7 yr. No serious adverse events or treatment related co-morbidities were reported. Sixty-five percent of the children still used melatonin daily and 12% occasionally. Temporal discontinuation of treatment resulted in a delay of sleep onset in 92% of the children. Nine percent of the children could discontinue melatonin completely because of improvement of sleep onset insomnia. Long-term melatonin treatment was judged to be effective against sleep onset problems in 88% of the cases. Improvement of behaviour and mood was reported in 71% and 61% respectively. We conclude that melatonin remains 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 or treatment related co-morbidity. Discontinuation of melatonin treatment usually leads to a relapse of sleep onset insomnia and in resuming melatonin treatment, even after several years of treatment.
5. Melatonin for Sleep in Children with Autism: A Controlled Trial Examining Dose, Tolerability, and Outcomes
AbstractSupplemental melatonin has shown promise in treating sleep onset insomnia in children with autism spectrum disorders (ASD). Twenty-four children, free of psychotropic medications, completed an open-label dose-escalation study to assess dose–response, tolerability, safety, feasibility of collecting actigraphy data, and ability of outcome measures to detect change during a 14-week intervention. Supplemental melatonin improved sleep latency, as measured by actigraphy, in most children at 1 or 3 mg dosages. It was effective in week 1 of treatment, maintained effects over several months, was well tolerated and safe, and showed improvement in sleep, behavior, and parenting stress. Our findings contribute to the growing literature on supplemental melatonin for insomnia in ASD and inform planning for a large randomized trial in this population.
6. Melatonin and HealthÂ
Melatonin is a ubiquitous natural hormone-like compound produced in the pianeal gland (embedded deeply in the brain) and by other tissues, for instance, in the gastrointestinal tissues. This hormone is involved in numerous aspexts of general circadian and physiological regulations. It sets and maintains the internal clocks governing the natural rhythms of body functions. Experimentally, melatonin modifies immunity, the stress respoinse and some aspects of the aging process. Clinically, melatonin has been used in rhythm distrubances, sleep disorders, and cancer. It possesses multifaceted and far-reaching biological effects. Melatonin was released into the general and naturaet in the spring of 1993. In the area of sleep disturbances, malatonin has been shown to effective in treating a condition known as delayed sleep phase syndrome and in corecting the disordered circadian rythms of jet lag and shift work. Researchers have studied the anticancer effects of melatonin, and it appears to work closely with vitamin B-6 and zinc in opposing the immunologic decline which normally accompanies aging.
A recent report described the use of melatonin to treat sleep disorders in hyperactive and neurologically compromised children: small nightly doses corrected the sleep problems, and investigators noticed improved mood and more stable and sociable dispositions tended to accompany the use of mleatonin with these children.
Melatonin also has exciting potential roles in ameliorating women’s health problems, such as osteoporosis, premenstrual syndrome, even birth control. As one of the body’s primary anti-stress hormones, it performs what are referred to as tonic and adaptogenic functions.
The Chemistry of Melatonin
Melatonin stabilizes the electrical actvity of the central nervous system and causes reapd synchronization of the elecytrical activity of te brin as well. In contrast, loss of the pineal gland predisposes animals to seizures. It has been proposed that the pineal, activn mostly but not exclusively through melatonin, is a “tranquilizing organ on behalf of homeostatic equilibrium”, and that it acts as a general synchronizing, stabilizing and moderating organ. This suggests that melatonin may have many applications for stabilizing and harmonizing aspects of brain function and chemical production.
7. Does long-term use of melatonin for children affect puberty? Based on research, no.
To establish whether long-term use of melatonin influences pubertal development, sleep quality and mental health development in children as compared with the normal Dutch population of the same age.
This follow-up research study was conducted in children included in a previous melatonin dose-finding trial. Outcomes were measured using questionnaires (Strength and Difficulties Questionnaire (SDQ), Children’s Sleep Habits Questionnaire (CSHQ) and Tanner Stages) adopted for Dutch children. Mean duration of therapy, persistence of effect, adverse events and (other) reasons leading to cessation of therapy were additional objectives of this study.
Mean years of usage (n=51) was 3.1 years (min 1.0 year, max 4.6 years), mean dose 2.69 mg (min 0.3 mg, max 10 mg). Mean SDQ score, mean CSHQ score and Tanner Stages standard deviation scores did not differ in a statistically significant way from published scores of the general Dutch population of the same age and sex.
This follow-up study demonstrates that melatonin treatment in children can be sustained over a long period of time without substantial deviation of the development of children with respect to sleep quality, puberty development and mental health scores, as compared with the general Dutch population.
8. Research shows that melatonin for kids is best dosed at 0.3 mg.
We examined effects of very low doses of melatonin (0.1-10 mg, orally) or placebo, administered at 1145 h, on sleep latency and duration, mood, performance, oral temperature, and changes in serum melatonin levels in 20 healthy male volunteers. A repeated-measure double-blind Latin square design was used. Subjects completed a battery of tests designed to assess mood and performance between 0930 and 1730 h. The sedative-like effects of melatonin were assessed by a simple sleep test: at 1330 h subjects were asked to hold a positive pressure switch in each hand and to relax with eyes closed while reclining in a quiet darkened room. Latency and duration of switch release, indicators of sleep, were measured. Areas under the time-melatonin concentration curve varied in proportion to the different melatonin doses ingested, and the 0.1- and 0.3-mg doses generated peak serum melatonin levels that were within the normal range of nocturnal melatonin levels in untreated people. All melatonin doses tested significantly increased sleep duration, as well as self-reported sleepiness and fatigue, relative to placebo. Moreover, all of the doses significantly decreased sleep-onset latency, oral temperature, and the number of correct responses on the Wilkinson auditory vigilance task. These data indicate that orally administered melatonin can be a highly potent hypnotic agent; they also suggest that the physiological increase in serum melatonin levels, which occurs around 2100 h daily, may constitute a signal initiating normal sleep onset.
9. Treatment of Sleep Disorders with Melatonin (smallest doses are sufficient)
10. Chamomile: A herbal medicine of the past with bright future
Chamomile is one of the most ancient medicinal herbs known to mankind. It is a member of Asteraceae/Compositae family and represented by two common varieties viz. German Chamomile (Chamomilla recutita) and Roman Chamomile (Chamaemelum nobile). The dried flowers of chamomile contain many terpenoids and flavonoids contributing to its medicinal properties. Chamomile preparations are commonly used for many human ailments such as hay fever, inflammation, muscle spasms, menstrual disorders, insomnia, ulcers, wounds, gastrointestinal disorders, rheumatic pain, and documented medicinal plants in the world and has been recommended for a variety of healing applications (7). Chamomile is a native of the old World and is a member of the daisy family (Asteraceae or Compositae). The hollow, bright gold cones of the flowers are packed with disc or tubular florets and are ringed with about fifteen white ray or ligulate florets, widely represented by two known varieties viz. German chamomile (Matricaria chamomilla) and Roman chamomile (Chamaemelum nobile) (8) . In this review we will discuss the use and possible merits of chamomile, examining its historical use and recent scientific and clinical evaluations of its potential use in the management of various human ailments.hemorrhoids. Essential oils of chamomile are used extensively in cosmetics and aromatherapy. Many different preparations of chamomile have been developed, the most popular of which is in the form of herbal tea consumed more than one million cups per day. In this review we describe the use of chamomile in traditional medicine with regard to evaluating its curative and preventive properties, highlight recent findings for its development as a therapeutic agent promoting human health.
Keywords: chamomile, dietary agents, flavonoids, polyphenols, human health
11. Medicinal Herbs 101: California Poppy
When taken as a flower essence preparation, California poppy can be used for finding spirituality within one’s heart. The California poppy flower essence, according to Patricia Kaminski and Richard Katz, is used for balancing light and love and developing an inner center of knowing. California poppy stabilizes the golden light of the heart, encouraging more self-responsibility and quiet inner development. Often times, those who would benefit from taking this remedy are mesmerized by social glamour and fame and become easily immersed in the life of media stars, and many other fleeting fads or causes. Such souls have the wide-eyed expectation that the spiritual gold which they seek can be found somewhere outside themselves. When taking California poppy, the soul can find the true treasure it seeks, the radiant sun force of the awakened human heart.
As an Herbal Tincture or Tea:
California poppy has been used by native American’s for generations for enhancing relaxation and reducing pain. It has been described that this native plant has sedative chemical components similar to that of the Opium poppy, yet are very safe and non-addictive. In fact, it is described in literature that California poppy is safe for most individuals including children. California poppy can be purchased in liquid extract (tincture) form or dried and used as medicinal tea. It combines beautifully with other herbs including skullcap, passion flower, and wild oat.
Reported Medicinal Uses:
- Anxiety or restlessness
- Sleep disturbances
- Acute or chronic pain
- Children experiencing tooth pain or bed-wetting induced by anxiety or nervousness.
12. A brief introduction to Lemon Balm
13. Is Echinacea safe in children?
One of several highly touted cold and/or flu fighters on the nutritional supplement market, which also include goldenseal, zinc lozenges, and vitamin C, echinacea is claimed to boost the immune system, thereby increasing one’s resistance to illness. The most well-studied of its actions is echinacea’s ability to stimulate phagocytosis, which is the process by which certain immune cells engulf and destroy foreign infectious organisms. Echinacea also appears to have mild antibacterial properties.
Many people who have tried echinacea, the purple coneflower (and relative of the sunflower) that grows wild on Midwestern prairies, swear by it in helping them fight off colds, flu, and other minor infections. Word-of-mouth among loyal echinacea users and extensive press coverage have helped make echinacea one of the best selling herbal supplements.
Since echinacea is sold as a nutritional supplement, which is not regulated by the U.S. Food and Drug Administration (FDA), your questions and skepticism are warranted. Many studies, most of them conducted by European researchers, have looked at the efficacy of echinacea as a remedy for colds, flu, and other minor infections. One by Braunig, B., et al. published in Zeitschrift fur Phytotherapie (13: 7-13, 1992), a German medical journal, is most commonly referred to since it shows echinacea’s ability to decrease the length and intensity of colds and flu. These researchers also found that 35 percent of the study group taking a specially prepared extract of echinacea did not become ill, as compared to 26 percent of the placebo group. However, more research is needed to see if American echinacea preparations will produce similar results, since American echinacea products may be manufactured differently or made from another part of the plant (or from a different species of echinacea altogether) than those used in European studies.
In another study published in July of 2005 in the New England Journal of Medicine, researchers at the University of Virginia found that echinacea neither prevents the common cold nor alleviates its symptoms. This study comes after a previous study published in the Journal of the American Medical Association showed that echinacea was ineffective in shortening the duration of colds or decreasing the severity of its symptoms in children between two and eleven years of age. Still, some experts call for more research with different cold viruses or species of echinacea, and/or higher doses. For more information, visit the National Center for
Complementary and Alternative Medicine website.
For those who are interested in echinacea, it is considered safe for most children, adults, and pregnant women to use. Side effects may include diarrhea, rashes, wheezing, and anaphylaxis (a potentially fatal allergic reaction). Echinacea is not recommended, however, for people who have the following:
- allergy to plants in the daisy family
- allergic rhinitis
- multiple sclerosis
- liver disorders
- connective tissue disorders
- other auto-immune and severe systemic disorders
Also, echinacea could damage the liver, especially if taken for longer than eight weeks (any potential benefits of echinacea would be greatly diminished or nonexistent after using it continuously for more than six to eight weeks, anyway). As such, it cannot be taken with other drugs that can harm the liver, such as anabolic steroids. Lastly, theory suggests that people are not to take echinacea with immunosuppressants, such as corticosteroids, since echinacea is supposed to enhance certain immune functions.
Echinacea is available in liquid extract/tincture (which is believed to be most effective), capsule/tablet, dried root/herb tea, and cream/gel forms. The different species of echinacea include Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida. Many people believe E. purpurea to be the most potent form of echinacea.
If you do decide to try echinacea, read the labels carefully. Choose preparations standardized to 15.0 percent of echinacasides, which are echinacea polysaccharides, the primary active ingredient of echinacea. Although most echinacea preparations are made from the whole plant, the fresh whole root extract/tincture of Echinacea purpurea manufactured by a European company, or even a large, established American company, is recommended. For liquid extracts, you may want to select alcohol-based preparations, which are generally stronger and better preserved than glycerin-based ones.
Since the strength of herbal preparations varies from one manufacturer to another, follow the label’s specific directions for use. According to the Herb Research Foundation, the recommended adult dosage for liquid extracts ranges from one to five droppersful (0.5 – 5 ml) taken three times a day. Half of the adult dosage is recommended for children under the age of ten years. Cream or gel preparations of echinacea, when applied to the skin, could help improve the symptoms of eczema, psoriasis, acne, boils, and other skin inflammations and infections, and could promote wound healing. It’s important to note that since echinacea has a short shelf life, you may want to refrigerate echinacea to help extend the time it’s effective.
As with any nutritional supplement or drug, it’s beneficial to consult your health care provider before taking echinacea. If while taking echinacea, symptoms worsen or persist after having taken echinacea for about four to seven days, stop taking it and see your health care provider for more appropriate treatment. Don’t take echinacea for pneumonia, strep throat, and other severe infections — these require a visit to a health care provider. Although some people supplement with echinacea daily to help enhance their immune systems during the cold and flu seasons, it is not recommended. After more than six to eight weeks, it becomes ineffective. Echinacea can become effective again following a break from it of at least two weeks. Of course, if you find that echinacea does not work for you at all, then discontinue using it.
14. Wild Lettuce Herbal Remedies
http://www.altmd.com/Articles/Wild-Lettuce-Herbal-RemediesWild Lettuce Herbal Remedies
Wild lettuce is a mild sedative and nervine and has been used in children’s cough medicines and in various remedies for nervous irritability. Because of its safety of use and calming effects, it is a good children’s remedy. Wild lettuce is most often combined with other sedative herbs. It loses its potency rapidly, so most commercial preparations are very mild. One way wild lettuce can be really effective is as a dried fresh-plant juice. It is a common garden and field weed throughout the northern hemisphere. Take the fresh green tops, juice them, pour the juice into a dehydrator tray for making fruit leather, dry the juice under low heat (under 100 deg.), then break the resulting herb “wafer” up into small flakes. Take 2-3 pinches of the wild lettuce dried juice flakes as needed. The flakes can also be stuffed into capsules if the bitter, salty taste is objectionable. Wild Lettuce has a taste of BITTER, SALTY and a temperature of COOL.
15. Correct Melatonin Dosage for Children
http://www.livestrong.com/article/465741-melatonin-dosage-for-kids/Dr. Peter Nieman, a member of the American Academy of Pediatrics and host of Healthy Kids Canada, points out that as many as 25 percent of children have difficulty falling asleep. Although the use of low doses of melatonin to help children sleep seems to be safe and effective, more research is needed to answer lingering questions. As with any dietary supplement, only give your child melatonin under a doctor’s direction.
The pineal gland is a small, pine cone-shaped organ located in the brain. It secretes the hormone known as melatonin. The hormone helps the body maintain its circadian rhythm — the internal clock that determines a person’s sleep-wake cycle. Darkness stimulates secretion of the hormone. Despite children having the highest levels of nighttime melatonin, some children do not produce enough of the hormone, which may be why they have sleep problems. According to the University of Maryland Medical Center, the use of melatonin supplements may reduce the time it takes to fall asleep, although research findings on its effectiveness have been mixed.
16. Is Melatonin Safe for Kids?
http://www.livestrong.com/article/522332-is-melatonin-safe-for-kids/The hormone melatonin is produced in the brain from the amino acid tryptophan and functions to regulate the body’s clock, or circadian rhythm. The circadian rhythm influences when your child wakes and falls asleep. The pineal gland responds to darkness by secreting more melatonin and responds to light by decreasing the hormone. Being exposed to insufficient light during the day or too much light at night interferes with the body’s natural melatonin cycles. Melatonin supplements help children with sleep problems associated with attention-deficit hyperactivity disorder and developmental disorders such as autism, mental retardation and cerebral palsy.
Melatonin and Insomnia
Children may experience insomnia related to ADHD, autism, cerebral palsy, mental retardation, visual impairment and other central nervous system disorders. Melatonin may reduce the time needed for some children to fall asleep and help them to sleep longer. The University of Maryland Medical Center reports that melatonin facilitates sleep for children with ADHD but does not benefit the symptoms associated with ADHD. Melatonin may decrease the number and length of seizures for children with epilepsy when taken at bedtime.