Pediatric melatonin consumption has risen more than fivefold since 2012

Pediatric melatonin consumption in the United States has risen more than fivefold since 2012, with related hospitalization increasing as well, according to data published Thursday in MMWR.

Melatonin is characterized in the U.S. as a dietary supplement and is widely used as an over-the-counter sleep aid. Its use has increased more than fivefold since 1999, with about 2.1% of adults reporting consumption in 2017 to 2018.

“Children are at increased risk for melatonin exposure because of the supplement’s widespread use and growing popularity as a sleep aid,” researchers wrote in MMWR. “In 2020, melatonin became the most frequently ingested substance among children reported to national poison control centers; however, more research is needed to describe the toxicity and outcomes associated with melatonin ingestions in children.”

The researchers studied melatonin ingestions reported to U.S. poison control centers and found they increased 530% from 8,337 in 2012 to 52,563 in 2021, with the largest yearly increase (37.9%) occurring from 2019 to 2020.

A total of 260,435 pediatric melatonin ingestions were reported during the study period. Of them, more than 94% were unintentional. Among 27,795 patients receiving care at a health care facility, 14.7% were hospitalized and 1% required intensive care, with five children requiring mechanical ventilation and two children — aged 3 months and 13 months — dying.

The largest annual increase coincided with the onset of the COVID-19 pandemic, they added.

“Unintentional ingestions were the primary drivers of this increase [during the pandemic],” they wrote. “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. Further, reports of increasing sleep disturbances during the pandemic might have led to increased availability of melatonin in the home.”

Due to the unintentional nature of most ingestions, the authors suggested child-resistant packaging for the supplement and more research for causes of increased melatonin ingestions among children.

“Increasing use of over-the-counter melatonin might place children at risk for potential adverse events,” they wrote. “Public health initiatives should focus on raising awareness of increasing melatonin ingestions among children and on preventive measures to eliminate this risk.”