According to the CDC, national data show they accounted for 7.1% of all emergency department visits for drug exposure in this age group.
This increase in childhood melatonin exposure is consistent with increased melatonin use in adults, the CDC noted. Research conducted from 1999 to 2018 suggests that the percentage of adults using melatonin increased from 0.4% to 2.1%. National Institutes of Health.
“What we often see with childhood melatonin exposure in young children is that the more things are in the house, the more likely the child will be exposed to melatonin,” says epidemiologist Maribeth Sivilas. . CDC.
Attractive and accessible for children
Melatonin is a hormone naturally produced in the body and released by the brain that affects sleep. Available as a supplement. Sybils said flavored formulations such as gummies and chewable tablets are appealing to children. And you may have easy access to these products.
Unlike standard medicines, there are no rules regulating supplement packaging, so most supplements do not have child-proof caps. Parents may also not be as careful about storing supplements as they are storing medications, Sivilas said. She noted that during the same period that children’s melatonin exposure increased, unsupervised drug exposure decreased overall.
“Maybe there’s a perception that there’s not that much of a risk,” Sivilas said.
Melatonin may pose risks to children
But there are also risks. Research shows that what’s on the label doesn’t always match what’s in the bottle.in study In the paper, published as a letter in JAMA last year, researchers from the Cambridge Health Alliance and the University of Mississippi tested 25 different melatonin supplements. They found that most products contained 20, 30, or 50% more melatonin content than what was listed on the label.
“I really don’t know what’s in there,” he said. Dahlia Long Gillespie, an emergency physician and spokesperson for the American College of Emergency Physicians. “They got a bottle of melatonin that someone bought at a gas station. It has melatonin in it, and it might have CBD in it.”
the majority of children were exposed Experts say low melatonin does not require hospitalization and symptoms are usually mild, including somnolence, nausea, vomiting, and headaches. Supplements are not regulated like medicines, so if more severe symptoms occur, doctors question whether the product may have been contaminated, she said. cora colette brunerprofessor of pediatrics and adolescent medicine and medical chairman of Seattle Children’s Hospital.
“I don’t recommend melatonin at all for people under 12, and even for people over 12, the problem is that the products themselves are very poorly regulated,” she says.
She also emphasized that melatonin is not an herb as many people think, but rather a hormone, and there are questions about its effects on the body.
“We don’t know what happens in the long term when we take hormones that can affect glucose metabolism, puberty, and many other things related to endocrine axis growth in the developing body and brain.” she says. . “This is very concerning because we’ve seen people giving children 10, 15, 20 milligrams a day and no one knows what that means. ”
Increased melatonin exposure in children
During the pandemic, parents said they sought over-the-counter medications to deal with sleep problems, resulting in an increase in melatonin in the home. caitlin brownClinical Managing Director of America’s Poison Centers, which represents 55 poison centers nationwide.
In 2012, there were 8,337 pediatric melatonin exposures reported to U.S. poison centers. That number reached 51,400 in 2020 and 52,589 in 2021, but has since dropped to 46,756 last year. American Poison Centers National Poison Data System.
“In fact, this is one of the leading substances of child exposure reported to poison centers,” Brown said.
Exposure to melatonin follows a typical age distribution, with intake among infants and 1- to 12-year-olds being mostly unintentional, while most intake among 13- to 19-year-olds is intentional and probably self-inflicted. She said it was related. -harm.
Exposure to melatonin may not require hospitalization, but it can stress the health care system by tying up emergency room personnel, emergency medicine doctors say.
“This is a ‘big problem’ in the sense that it consumes resources,” he said. Michael Tothsaid in an email, assistant professor of pediatrics in emergency medicine and medical toxicology at Boston Children’s Hospital.
Exploratory melatonin ingestion by young children can increase wait times in emergency departments, while intentional or self-inflicted poisonings seen in teenagers can lead to unresolved problems while awaiting transfer to a psychiatric hospital. Dr. Torse wrote that he could be admitted to the hospital for days. Email.
“There are significant costs to patients and families,” he said. Marian Amirshahiprofessor 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 the age of 5, it’s very stressful for the family,” said Amirshahi, who is also comedy director at the National Capital Poison Center. Depending on the insurance company, parents may have to pay a portion of the hospital bill.
Poison control authorities hope increased exposure to melatonin will lead to improved packaging.
“Packaging reform is definitely something we’re looking at and we’re starting discussions with our legislators,” he said. Varun Vohraa clinical toxicologist and director of the Michigan Poison and Drug Information Center at Wayne State University School of Medicine.
“We often bear the brunt of these exposures through calls to poison centers, so we not only urgently assist in the management and treatment of these exposures, but also help prevent exposures upstream. It is also part of our duty to find ways,” he said. .
