Doctors warned to be careful when prescribing melatonin for young children
06 Feb 2026
Experts say sleep behaviour strategies should be tried first, especially for children with typical development.
The review looked at 19 international studies on melatonin use in young children. It found that prescriptions have increased over time, with some studies reporting rises of up to 500%. There has also been an increase in long-term use and overdoses in children aged six and under.
While a small number of trials showed that melatonin helped children with autism spectrum disorder (ASD) or related conditions fall asleep faster, none of the studies looked at long-term effects beyond two years. There was also no evidence to support melatonin use in children with typical development.
Researchers said the findings point to a global rise in melatonin prescribing without clear proof that it works or is safe for long-term use in most children. They recommend that doctors focus on behavioural sleep strategies before considering medication, to reduce unnecessary use and overdose risk.For children with ASD, the authors suggest melatonin should only be considered after behavioural approaches have been tried, and always with medical supervision and regular follow-up. Even in these cases, long-term monitoring is needed if use continues beyond three years.
The study also highlights safety concerns. In the United States, melatonin is now the most common substance involved in unsupervised medication ingestion among children under five, with overdose cases increasing fivefold between 2009 and 2021.
In Australia, the Therapeutic Goods Administration has raised concerns about the quality of some melatonin products bought online. Testing found many products did not match their labelled dose, including one with more than four times the stated amount. An ABC investigation also reported nearly 1500 calls to poison helplines in 2024 linked to melatonin exposure in children.
RACGP child health chair Dr Tim Jones said the research shows melatonin use has grown quickly without solid evidence for neurotypical children. He encouraged GPs to focus on practical sleep support for families and, if melatonin is used at all, to keep it short term, closely monitored, and combined with non-medication strategies.
https://www1.racgp.org.au/
