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Doctors urge caution as more parents use melatonin to help their kids sleep

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Bedtimes became a hassle for Lorien’s neurodivergent son about a year after moving out of Vancouver to B.C.’s Kootenays. The lack of sleep that came with it was having an effect on his behaviour, his relationships and his happiness.

That’s why, after hearing a conversation in a health store that melatonin can be used for sleep, including with children, she thought she would give some to her son.

“One of the things that they had really emphasized in that conversation … [was] low dose is key,” she said. “What you want to do is give your child just that little tiny nudge towards sleepiness, not knock them off the cliff.”

Lorien, whose last name we’re not using to protect her child’s privacy, said it’s been working as expected so far.

“I started with just literal drops, and all of a sudden it was enough that at 20 minutes after taking them, we’d be all tucked in with our bedtime story and he would just feel sleepy,” she told The Current’s Matt Galloway.

Melatonin is a hormone that humans produce naturally through the brain’s pineal gland, and supplements can be bought over the counter as a sleep aid. And according to research in the U.S., it’s growing in popularity.

One study, published in the Journal of the American Medical Association last year, found that melatonin use “significantly increased” from 1999 to 2018 across all demographics.

Dr. Michael Rieder, a pediatrics professor at Western University in London, Ont., says melatonin helps regulate a brain’s circadian rhythm — a system of physical, mental and behavioural changes that follow a 24-hour cycle.

“It’s been shown quite clearly, for instance, that if you have a disturbance in circadian rhythm … melatonin can help reset the circadian rhythm back to where it’s supposed to be,” he told Galloway.

An increasing number of parents are giving their restless children melatolin as a sleep aid, but some doctors are raising concerns about it. (Shutterstock)

Different effects on different kids

Dr. Suresh Kotagal, a professor emeritus in the department of neurology at the Mayo Clinic in Rochester, Minn., said it’s understandable why parents like Lorien turn to melatonin to help with their child’s sleep issues.

“Sleep is so important for children because it’s only when they have good, sound sleep at night that restorative functions in the brain start clicking,” he told Galloway.

“And the next day, after a good night of sleep, children are able to stay more alert and be happier and learn better.”

But he says that doesn’t mean melatonin is a suitable supplement for every child.

“In typically developing children who don’t have autism, I think I would look elsewhere for an answer to improving sleep rather than melatonin first,” he said.

According to a 2019 study published in the National Library of Medicine, 50 to 80 per cent of children with Autism Spectrum Disorder experience sleep disorders, compared to nine to 50 per cent of neurotypical children.

Kotagal, who’s also the chair of the World Sleep Society’s task force, said there are studies that show the enzyme Acetylserotonin O-methyltransferase (ASMT), which is important for the body to make melatonin, is deficient in children with autism.

“So indeed, when we give melatonin to children with autism or other neurodevelopmental disabilities, we are improving or increasing the levels of melatonin in them,” he said.

A row of melatonin containers sit on a shelf.
Canadian sleep and drug safety experts say melatonin use has increased but that the supplement may not be beneficial for everyone. (CBC)

He and his peers are doing their own rigorous analysis of published data on melatonin use in children with autism and other neurodevelopmental disabilities between 2012 and 2022. They’re trying to learn more by studying roughly 850 neurodivergent children.

Still, he said evidence shows melatonin is helping children with autism and neurodevelopmental disabilities sleep better. But he says the evidence isn’t as clear with other children who just have difficulty sleeping.

Lorien’s son hadn’t yet been diagnosed with inattentive-type ADHD when she first got melatonin for him. But she said that at that point, “the risk of doing nothing was that my child was having a really, really hard time with sleep” and other aspects of daily life.

“So to me, the very small risk of the unknown was offset by the need to not just do nothing,” she added.

 

Melatonin won’t help everyone’s sleep issues, experts say

The use of melatonin as a sleep aid has significantly increased over the past two decades, but experts say it isn’t a cure-all, and taking too much can cause health problems.

Understanding the risks

Although the evidence for melatonin use in neurotypical children is soft, the supplement is widely used regardless.

That’s concerning to doctors such as Rieder, because he says there’s a risk of parents giving too much melatonin to their children.

“Melatonin doses that work in kids are very small. You don’t have to give a lot of melatonin to work,” he said. “The problem was if you give it [and] it doesn’t work, there’s a natural tendency to think, ‘Maybe they just need to go a little bit more.'”

Rieder said melatonin can be bought in a 10-milligram tablet, which is the right dose for an adult, but too much for a child.

But because it’s usually sold as an over-the-counter supplement in Canada, there’s no intermediary that can prevent parents from giving their children unnecessarily large tablets.

“You can go into your into your pharmacy and use a self-check and not even speak to a human person at all to get this dose,” he said.

According to data provided to The Current by SickKids, which operates the Ontario Poison Centre, the number of melatonin-related calls from Ontario, Manitoba and Nunavut for children five and under increased every year from 2017 (160 calls) to 2021 (438 calls.)

Lorien, who has started taking melatonin supplements along with her other child, understands this risk. That’s why she’s taking precautions such as breaks in usage to prevent overdose.

“We literally use scissors and we cut them into quarters in order to keep that dose low where we want the kids to be taking it,” she said.

 

Dr. Brian Goldman’s top five tips for overcoming insomnia

Are you having trouble sleeping? So are one in five Canadians. Dr. Brian Goldman shares his top tips to fall asleep, stay asleep and feel refreshed the next day.

Nevertheless, Kotagal suggests looking at other solutions to help tackle sleep issues.

He said if a child is below the age of two, nearby noise or medical issues may be the problem and those should be looked at first.

“When we come to older children, I would try behavioural sleep measures first. Go, if possible, discuss that with the primary care provider or sleep specialist.”

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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