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They accounted for 7.1 percent of all emergency department visits for drug exposure for this age group, according to national data, the CDC said.
This increase in pediatric melatonin exposure coincided with increased melatonin use among adults, the CDC noted. A survey conducted between 1999 and 2018 suggested that the proportion of adults consuming melatonin increased from 0.4 to 2.1 percent, according to the National Institutes of Health.
“What we tend to see with these pediatric exposures to melatonin among young children is that if there is more of something in the home, there will be more incidences of children consuming it,” said Maribeth Sivilus, an epidemiologist at the CDC.
Attractive and accessible for children.
Melatonin, a hormone produced naturally in the body and released by the brain, influences sleep. It is available as a supplement. Flavored formulations, such as gummies and chewable tablets, are appealing to children, Sivilus said. And they may be able to easily access these products.
Unlike standard medications, there are no rules governing the packaging of supplements, so most do not have child-resistant caps. Parents also may not put as much care into storing supplements as they do with their medications, Sivilus said. He observed that in the same period that melatonin exposure increased among children, overall exposure to unsupervised medications decreased.
“Maybe there’s a perception that there’s not as much risk,” Sivilus said.
Melatonin may pose a risk to children
But there is a risk. What’s on the label isn’t necessarily what’s in the bottle, research shows. in a study Published as a letter in JAMA last year, researchers from Cambridge Health Alliance and the University of Mississippi tested 25 melatonin supplements. They found that most products contained 20, 30 or 50 percent more melatonin than what was listed on the label.
“We really don’t know what’s in it,” he said. Darria Long Gillespie, emergency physician and spokesperson for the American College of Emergency Physicians. “They have a bottle of melatonin that someone bought at a gas station, you know, and it has melatonin in it, and it might contain some CBD.”
The vast majority of children exposed to melatonin do not require hospitalization and, if symptoms occur, they are usually mild and include drowsiness, nausea, vomiting or headache, experts said. When more severe symptoms arise, doctors question whether there has been possible contamination in the product, since supplements are not regulated like medications, he said. Cora Collette Breunerprofessor of pediatric adolescent medicine and president of the medical staff at Seattle Children’s Hospital.
“I don’t recommend melatonin at all for those under 12. Even for those over 12, the problem is that the product itself is very poorly regulated,” he said.
He also highlighted that melatonin is not a herb, as many people think, but a hormone, and there are doubts about its effects on the body.
“We don’t know, with a developing body and brain, what happens to you in the long term if you take a hormone that could affect glucose metabolism, puberty and a number of other things that are in the growth of the endocrine axis.” , said. . “I’ve seen people give their children 10, 15, 20 milligrams a day, and that’s very alarming because who knows what that means.”
Growing number of melatonin exposures among children
During the pandemic, parents sought over-the-counter remedies to address sleep disruptions, and that resulted in more melatonin at home, she said. Kaitlyn Brownchief clinical officer of America’s Poison Centers, which represents 55 poison centers nationwide.
There were 8,337 pediatric melatonin exposures reported to U.S. poison centers in 2012. Those numbers reached 51,400 in 2020 and 52,589 in 2021, though they have since decreased to 46,756 last year, according to the National Poison Data System from US Poison Centers.
“It’s actually one of the top exposure substances reported in poison centers in children,” Brown said.
Melatonin exposures follow the typical age distribution, he said, with ingestions among infants and children ages 1 to 12 being largely unintentional, while most ingestions among children ages 13 to 19 are intentional and They are possibly related to the autopsy. -to damage.
Exposure to melatonin may not require hospitalization, but it can stress the health care system by busying emergency room staff, emergency room doctors say.
“It’s a ‘big problem’ in the sense that it consumes resources,” he said. Michael Toceassistant professor of pediatrics in emergency medicine and medical toxicology at Boston Children’s Hospital, in an email.
Exploratory melatonin ingestions by young children can increase emergency department wait times, while intentional or self-harm poisonings seen in adolescents can land them in the hospital for days, while they await transfer to a psychiatric hospital for treatment. inpatients, Toce wrote in an email.
There is also a “significant cost to patients and families,” he said. Maryann Amir Shahiprofessor of emergency medicine at Georgetown University School of Medicine and emergency medicine physician at MedStar Washington Hospital Center.
“If you’ve ever sat in a waiting room for 12 hours with a child under 5, that really puts a lot of stress on the family,” said Amirshahi, who is also co-medical director of the National Capital Poison Center. Parents may also have to pay a portion of the hospital bill, as some insurers require.
Poison control officials would like the increased exposure to melatonin to lead to better packaging.
“Packaging reform is something we are certainly looking at and starting discussions with our own legislators,” he said. Varun Vohraclinical toxicologist and director of the Michigan Poison and Drug Information Center at Wayne State University School of Medicine.
“We see much of the brunt of these exposures, with calls to our poison centers, so part of our duty is to help manage and treat those exposures acutely, but also look for ways to prevent exposures at earlier stages.” , said. .