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’sMatt 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.
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 Clinicin 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.
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.
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.
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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.”
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
