Melatonin and Babies
In recent years, melatonin has become a bit of a buzzword amongst sleep deprived parents looking for a solution to their children’s sleep issues. But what exactly is melatonin and what does it have to do with sleep? And could melatonin supplements be the magic cure to your baby’s sleep woes? Read on to find out!
What is melatonin?
Put simply, melatonin is a hormone produced in the pineal gland that helps with both sleep onset and regulating sleep patterns.
Every human being has an in-built circadian rhythm or “body clock” that is controlled in the hypothalamus in the brain. This rhythm is established in response to changing light levels over a 24 hour period. When the sun comes up, the hypothalamus stimulates the release of hormones that help to wake us up. When the sun sets and light levels start to decrease, the hypothalamus prepares the body to fall asleep by releasing melatonin from the pineal gland.
Melatonin levels typically start to rise about 2hrs before our regular bedtime, putting us in a quiet, relaxed state so that we are ready to fall asleep. The continuous release of melatonin overnight then helps us to stay asleep! Melatonin levels tend to peak between 2-4am and then ease off again in preparation for waking.
Melatonin is sometimes referred to as the “darkness hormone” since it is only secreted from the pineal gland when it is dark. Exposure to bright light suppresses the release of melatonin which can lead to difficulties falling asleep and staying asleep.
How do babies produce melatonin?
During pregnancy, a baby’s circadian rhythm is largely determined by the mother’s activity levels. When the mother is active, the baby’s heart and respiratory rates will speed up and when the mother is resting or sleeping, they will slow down again. Maternal melatonin also passes through the placenta, which helps babies to sleep when their mother is sleeping.
After birth this placental connection is broken, however, melatonin can still be passed on to babies through breast milk. The baby’s pineal gland will also be activated immediately after birth, meaning they will start to produce their own melatonin. Unfortunately, melatonin is only released in extremely small amounts to start with but this will increase with age.
In addition to producing their own melatonin, babies will also start to develop their own circadian rhythms post-birth. Initially, their sleep patterns can be quite erratic and some newborn babies will also experience day/night confusion. Somewhere between 8-16 weeks of age their circadian rhythms will mature and they will start to fall into more predictable sleep patterns.
What stimulates melatonin production in babies and toddlers?
Since melatonin is only produced when it’s dark, one of the biggest things that can help to stimulate melatonin production is sleeping in a dark room. For babies and toddlers under 2 years old, we recommend having a dark room for both naps and overnight sleep. This can help your baby to settle and fall asleep quicker and link their sleep cycles too.
Toddlers and children over 2 years of age can develop a genuine fear of the dark though - in this case you may need to use a nightlight for reassurance. Where possible, we recommend using a red light, as this has been shown to have minimal impact on melatonin production. Blue light should be avoided, especially in the 2hrs before bedtime, as this suppresses melatonin more than any other colour of light.
Since the body’s circadian rhythm triggers the release of melatonin, having a consistent bedtime routine can also help to stimulate melatonin production. To establish a routine for your baby, we recommend:
- Waking them at the same time each morning to help “set” their body clock.
- Making sure their nap times and lengths are appropriate for their age. This helps to build sleep pressure throughout the day, so that they are able to sleep well overnight.
- Keeping a consistent bedtime. For younger babies, under 6 months old, this should ideally be no more than 2 hours after waking from their last nap of the day. For older babies and toddlers, this can be anywhere from 4 hrs-5.5hrs after waking from their nap, just depending on their age and nap length.
Bedtime battles are one of the most common sleep challenges we are asked about and whilst melatonin production can play a part in this, usually the difficulties settling are due to other factors like under or overtiredness, hunger, overstimulation or developmental leaps/milestones.
Some other strategies that can help with settling at bedtime include:
- Having a relaxing and predictable bedtime routine
- Avoiding stimulants such as caffeine and sugar in the 2hrs before bedtime
- Avoiding screen time in the 2hrs before bedtime - this includes TVs, computers, tablets and smartphones
- Getting enough physical activity each day
- Eating dinner at least 2hrs before bedtime to allow time for digestion
Can you give melatonin supplements to a baby?
For parents who have experienced ongoing challenges with their baby’s sleep, they can start to wonder whether their baby is producing enough melatonin. Melatonin supplements can seem like a quick and easy solution to their baby’s sleep woes! The truth is there are many, many reasons why babies and children may struggle to fall asleep and stay asleep. These can include:
- Under or overtiredness
- A sleep environment that is not conducive to sleep
- Physical health issues such as teething, illness, reflux etc.
- Nutrient deficiencies (particularly iron)
- Reliance on parent-led sleep associations such as patting or rocking to sleep
- Behavioural changes
- Nightmares or night terrors
- Neurodevelopmental differences such as ADHD and autism
Before considering melatonin supplements for your baby or child, it is important to see your doctor for a thorough evaluation of their health and sleep. Generally speaking, melatonin supplements are not recommended for children under the age of 3 years old, as sleep difficulties at this age are almost always environmental or behavioural in nature.
In some cases though, particularly in children with neurodevelopmental differences like ADHD and autism, the pineal gland does not secrete enough melatonin at night. This is where supplemental melatonin can be effective, alongside environmental changes and behavioural interventions. Melatonin has also proven to be effective in combating temporary sleep issues like jet lag.
The availability of melatonin supplements varies depending on where you live in the world. In some countries, it is available over the counter in the form of liquids, gummies, pills, and chewable tablets. In other countries, melatonin is only able to be prescribed by a doctor.
Melatonin supplements appear to be safe for short-term use but as of yet, there have been no long-term studies into melatonin use in children. It’s also important to note that, like other supplements, melatonin is not regulated in the same way as medications are - this means they are not tested for safety or effectiveness and the amount of melatonin that supplements contain can vary from one batch to the next.
Side effects of melatonin use in children are rare but prolonged use or overuse of melatonin has been reported to cause:
- vivid dreams
- redness of the cheeks, earlobes, and eyes
- feeling cold
In summary, melatonin supplements can be effective in treating some sleep issues but are generally not recommended for children under 3 years of age. If your baby’s experiencing difficulty falling asleep, there are other strategies you can implement to help with this.
How can I naturally improve my baby’s sleep?
There are three key factors that can help to improve your baby’s sleep:
- 1. The sleep environment
- 2. Their awake times and nap lengths
- 3. How they are settled to sleep
1. The sleep environment
Around 8 weeks old, babies will go through their first sleep regression - this is when their newborn sleepiness wears off, so their ability to produce melatonin becomes much more important! At this age, many parents report that their babies will become difficult to settle for naps or will start catnapping - waking after one cycle of around 40-45 minutes. Making some changes to their sleep environment now can help them to settle quicker, fall asleep and sleep for longer.
We recommend a dark room for both naps and overnight sleep up until 2 years old - after that you can introduce a red night light if your toddler develops a fear of the dark. Blackout blinds are an effective way to get the room as dark as possible during the day.
For younger babies who aren’t rolling yet, we recommend swaddling them for naps and overnight sleep as this helps to suppress their startle reflex. For older babies who are rolling, a sleeping bag or sleepsuit with legs is a good option. This can help to prevent them getting tangled in blankets or kicking off the blankets and getting cold.
White noise can also be a very effective tool for settling and can help babies to drift between sleep cycles instead of waking fully - especially during naps and in the early morning when sleep pressure is lower.
You can find a list of recommended sleep products here: Products We Recommend
2. Awake times and nap lengths
At any given age, a baby will require a specific amount of sleep over a 24hr period. This means that if they are having too much sleep during the day, they will be undertired at bedtime, causing them to wake more overnight. On the other hand, if they aren’t getting enough sleep during the day, this can then make them overtired which can also cause more overnight waking!
Here is a rough guide for how much cumulative day sleep your baby needs at each age, to allow for 12 hours sleep at night (including feeds for younger babies):
2-4 weeks: 5 hours sleep (3 naps)
4-6 weeks: 4 ¾ hours (3 naps)
6-8 weeks: 4 hours (3 naps)
8-12 weeks: 3 ½ hours (3 naps)
3-6 months: 3 hours (3 naps)
6-9 months: 2 ½ hours (2 naps)
9-12 months: 2 – 2 ½ hours (2 naps)
One of the easiest ways to regulate your baby’s sleep is to wake them at the same time each morning and aim for similar nap times each day. If your baby is having too much sleep during the day, then you may also need to wake them from naps so that they will be tired enough to settle and sleep well overnight.
If you are struggling with catnapping throughout the day, then your baby’s awake time between naps may also need a bit of tweaking. Our Ultimate Sleep and Nutrition Program can help with making sure awake times are spot on for your baby’s age, which prevents both over and undertiredness - two of the main reasons why a baby will be hard to settle or wake early from naps.
If your baby is over 3-4 months old though, you may also need to look at how they are settling to sleep...
Around 3-4 months your baby’s circadian rhythm will mature, which means you should start to see some more predictable sleep patterns emerge. This doesn’t mean they will be perfect sleepers though! In fact, some babies who were sleeping well previously, can start to wake more frequently around 3-4 months due to the sleep regression at this age.
This regression is a permanent change to your baby’s sleep patterns where they will start to wake fully in between sleep cycles - roughly 40-45 minutes into naps and every 2hrs from midnight. If your baby relies on a parent-led sleep association at the start of naps and bedtime such as patting, feeding or rocking to sleep, they will need that same help to resettle themselves when they wake between sleep cycles now.
Once the 4 month regression hits, working on self-settling is the key to improving both their naps and overnight sleep. Focus on the start of naps and bedtime to begin with and this will give your baby the best chance at resettling themselves when they wake in between sleep cycles overnight. Our Ultimate Sleep and Nutrition Program contains several gentle methods to choose from if you are wanting to guide your baby towards self-settling.
Melatonin is a hormone produced in the pineal gland that helps with both sleep onset and regulating sleep patterns. The release of melatonin is strongly linked to our circadian rhythms or “body clock” which responds to changes in light levels. This means that melatonin is only released when it is time for us to sleep - in other words, when it is dark!
Babies begin to produce their own melatonin from birth but the amounts are extremely small to begin with, meaning that a newborn baby’s sleep patterns can be quite erratic in the early days! As babies get older, their melatonin levels increase and their circadian rhythm begins to develop and mature - this usually happens somewhere between 8-16 weeks of age.
To stimulate the production of melatonin, we recommend sleeping your baby in a dark room for both naps and overnight sleep. Waking them at the same time each morning and aiming for consistent naps each day can also help to develop their circadian rhythm.
Melatonin supplements can seem like a quick and easy fix for your baby’s sleep challenges but these are generally not recommended for children under the age of 3 years. For older children and adults, melatonin supplements can sometimes help to address sleep issues in the short term but this should always be discussed with your doctor first.
For most children, especially those under the age of 3 years, difficulty falling asleep or staying asleep are usually environmental or behavioural in nature. This means that their sleep can often be improved with other strategies such as making changes to their sleep environment or bedtime routine. Older babies and toddlers may also need help to develop independent settling skills.
In summary, melatonin supplements are not a substitute for good sleep practices! If you are experiencing difficulties getting your baby to fall asleep or settle, our Ultimate Sleep and Nutrition Program can help to get things back on track.
Getting rhythm: how do babies do it
Light, melatonin and the sleep-wake cycle
Physiology of the pineal gland and melatonin
The Effects of Red and Blue Lights on Circadian Variations in Cortisol, Alpha Amylase, and Melatonin
The use of MElatonin in children with neurodevelopmental disorders and impaired sleep: a randomised, double-blind, placebo-controlled, parallel study (MENDS)
Sleep in Children with Autism Spectrum Disorder
Safety, Tolerability and Efficacy of Drugs for Treating Behavioural Insomnia in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review with Methodological Quality Assessment