There are times with children that they just won’t fall asleep at their normal bedtime.  They are up until midnight, and they are cranky but just won’t fall asleep.  You want to pull your hair out and you are willing to try anything to help them get back on their normal sleep schedule.

After trying various ways to get your child with a feeding tube back onto their sleep schedule, it may be time to try melatonin.  Melatonin can be a good short term sleep solution.  Let’s go over the different options for melatonin in a feeding tube like a G tube or GJ tube.

Reasons for Sleep Schedule Change

There are many reasons a disturbance to a sleep schedule can happen that are not directly related to an underlying disorder or medical condition.  The most common reasons are:

1. Extended Hospital Stay– if you have ever tried sleeping in a hospital where they are constantly checking your blood pressure and other vitals, it is easy to see why this would disturb a sleep schedule.

2. Daylight Savings Time Change- Both of my kids are affected by this one every year.  We finally get them on a good routine, and the time change totally messes up their schedule.

3. Daily Schedule Change- This is most common when a child starts school or daycare.  The new shift in routine wake-up times can greatly affect their going to bedtime.

4. Changes in Environment- When we moved my daughter from her crib to her to toddler bed, this caused some sleep schedule disruptions due to the new sleeping area.

5. Sickness- When you are up all night multiple times due to any kind of illness like a stomach virus, this can cause more sleeping during the day, and totally shift the natural circadian rhythm of your sleep schedule.

6. ADHD and Autism– I’m including this one in the list because these two conditions go hand and hand with sleep schedule disruptions in children a lot.  Over stimulation can cause the brain to not “shut down” enough to fall asleep at regular times.

How does Melatonin Help Sleep in Kids?

According to NCCIH, melatonin is a hormone that your brain produces in response to darkness. The circadian rhythm is what your body reacts to in order to know when to fall asleep. Exposure to light can actually prevent the body from producing melatonin.

Short term use of melatonin supplements to help correct sleep issues appears to be safe for most people.  Always consult your doctor first about using melatonin and which dose you should take or give to a child.

Melatonin is considered a dietary supplement which means it is regulated by the Food and Drug Administration but not as strictly as prescription or over the counter medicines.

After talking to your physician, they may write you a prescription for melatonin instead of recommending a supplement that is available with no prescription. 

Basically, a melatonin supplement helps increase your feeling of being sleepy and increase your chances of falling asleep quicker.  It does not cause drowsiness like a medication, and it will not help you stay asleep.

Types of Melatonin 

Melatonin can come in many forms like a traditional pill, gummy, dissolvable/chewable tablet, a spray, a powder or a liquid.  If your child is able to safely take a gummy or dissolvable/chewable tablet, these may be your best options.

If your child is fully tube fed, then you may want to explore powder or liquid forms.

During and after stays at our local children’s hospital, we gave my daughter liquid melatonin via g tube.  This helped try to correct her schedule for sleeping during the night instead of during the day.

It was mostly effective for us when we used it in combination with her normal bedtime routine for about 2 weeks after we got home. 

Melatonin is best when given 30 minutes before bedtime.  We gave it with her other nighttime medicines and had no problems.  It is best to check with your physician and your pharmacist to make sure that there are no drug interactions.

Melatonin Alternatives

Before using melatonin, we did try some more “natural” options.  Some tips to try at home would be:

• limit screen time (tv and tablets) before bedtime. Preferably more than 2 hours before bedtime routine.
• play soft music at bedtime
• shorten day time naps or try to make the nap occur earlier in the day.
• warm bath before bedtime
• set an established wake up time every day
• light blocking curtains
• getting lots of natural sunlight during the day
• cuddling together before bed
• letting them pick their pillowcase, sheets, or blanket to make bedtime more enjoyable

All of these tips can help an occasional disruption to a sleep schedule but are more behavior based.  When the sleep schedule is disrupted by outside forces like medical treatment, it can be harder to correct.

Where to get Melatonin for kids?

When choosing any dietary supplement, we always want to strive for the following:

• made in the US
• no excessive medical claims (example: that it cures insomnia)
• dosage
• clear ingredient list (important if any allergies to gluten, dairy, soy, etc)

Powder:

Powdered Melatonin is very simple to mix with water, juice or with formula.  It is very similar to using Miralax in a feeding tube. 

Natural Vitality makes a powdered drink mix that is gluten and vegan. It also has magnesium and calcium.  It does have a berry flavor so it can be taken by mouth or given by G Tube.

Gummy: 

Zarbees makes a really good gummy melatonin that is easy to take by mouth.  If your child is not able to take by mouth, you can put the gummy in a few mls of water, and it will dissolve!  It usually takes about 30 seconds to fully dissolve and then you can use a syringe to put it in a feeding tube.

Liquid:

SleepBerry makes a liquid melatonin that is simple to mix with a couple mls of water, juice, or formula.  It comes with a little dropper to measure the dosage.

Now that my daughter can eat by mouth, we actually put the liquid melatonin in a pouch with yogurt and her Prilosec at night before bed.  It has a slight berry flavor but it is mostly masked by the yogurt.

This one is the easiest to give by feeding tube because it is already in a liquid form.  Just remember to flush the extension after the dose is given.

 

Dissolvable Tablet:

Natrol Kids makes a dissolvable tablet that is really easy to give by mouth.  My 5 year non-tubie says they taste like berry candy.  My 2.5 tubie girl, did not like the dissolving feeling at all!

So, we put the tablet in a medicine cup and added a few drops of water.  After a few seconds, you can shake the cup a little and see that it is fully dissolved.  This liquid can be pushed through a g tube or be given orally (can add to applesauce or yogurt too!).  Make sure that it is fully dissolved and not chunky before giving by feeding tube or this may cause a clog.  We like to flush with water afterwards to make sure none of the granules stick in the tube.

Pill Form:

Some prescriptions will come in a pill form and these are easy enough to modify for a feeding tube if your child can’t take pills.

Simple place the melatonin pill in a 10ml syringe with no needle.  Then draw up 5 ml of water. Cover the tip of the syringe with your finger or thumb and draw back on the plunger a few times.  This should fully dissolve the pill.  

It may take a couple of tries to get this down, but it is very easy to master!  Here is a YouTube video of how it is done:

Melatonin and Kids Long Term

For most kids in most situations, melatonin can be used safely to correct sleep schedule changes.  It usually take less than 30 days to get the schedule back on track and then you can stop giving the melatonin every night.

We are usually able to correct sleep times in about 2 weeks but sometimes longer hospital stays did take longer.

Our dosages are always very low, but you want to consult with your doctor about dosing.  Sometimes you will need to start at a lower dosage and slowly move up over time.

Melatonin has not shown any long-term negative side effects in children.  As a precaution we do want to make sure our medical team knows of every thing we take in case of drug interaction, but melatonin rarely reacts with other medications.  Always double check with your pharmacist!

Short term side effects that have been seen occasionally include upset stomach and headache.  These are pretty rare though and may actually be due to fillers and not the melatonin itself.

Hopefully short-term use of melatonin is helpful to you to get your child’s sleep schedule back on track! Happy Sleeping!