I Nearly Dialed 9-1-1

Whenever I’ve been out with my two kids, and we return home, I like to give my son a little freedom to make his way into the house. He enjoys the outdoors and has certain spots he likes to check to see if any animals have appeared. In particular, he’s always on the hunt for frogs and rabbits. After all, we’re in a semi-rural location with some land and lots of places to explore.

Today, just after noon, we returned from some errands. I took LL from her carseat and set her on my hip before picking up the myriad bags I needed to take inside. I hollered for BB to come along so we could eat our lunch. He scampered up behind me and I heard his heavy footfall on the porch behind me. I rounded the corner and made it to the door. Once inside, I set LL down to play and put all my bags on a shelving unit near our front door. I couldn’t have been inside more than one minute, but I couldn’t hear BB anymore.

I stepped back outside and looked around. Didn’t see him. I walked back to the parking area. Not there either. As LL watched from the living room window, I walked around looking in all of his usual haunts. When I couldn’t find him there, I went back up to the front of the house and looked around. Still didn’t see him. I started to get concerned. I went back to the parking area and walked down to the street level. I looked up one side of the sidewalk and down the other. I peered across the way to a park we frequent. Still no sign. I was getting frantic at this point. I started calling his name in that scary broken voice of panic. Nothing.

My mind was swimming. What if he got too close to the road and someone had picked him up? But, how? He was out there for no more than a minute and he had been on the porch. Where could he be? I walked back up to the front of the house still calling even more terrified. I started to walk to a small man-made pond near the house when I saw him. He was running toward me happily yelling “VULTURE!!” He had gone down near the water feature to look at a volt of vultures that had been sunning themselves along a wrought iron fence surrounding the water. But, because of the topography of the land, I couldn’t see him from the house.

He hadn’t done anything wrong per se. He was in a location we visit often together. He hadn’t gone past the “line” which is a joint in the concrete of our parking area beyond which is a busy state highway. He is very good about stopping at the line and never crosses it without an adult present. He also knew from experience that I curtail his adventures for a while when he ignores a safety limit. Whenever that happens, I hold his hand all the way into the house to make sure he’s ok. It takes time for me to trust in his judgment again.

But, this time, he followed the rules. All except for announcing himself or coming to me when I called. However, thinking back, it was probably a very short amount of time between when I first started calling and when he showed up. It just felt like an eternity when I thought I’d lost him.

This is where it gets really tough. How do I give him freedom to learn to be responsible and protect his safety at the same time? I’ve been thinking about the situation all day since it happened and I realized that my next step is to set a firmer boundary on the side of my house near the water feature. He needs a physical marker to know where to stop. I also need to work on having him respond or return when I call.

But, what I will not do is punish him for being a kid who respects the rules we already have in place. Even though my mommy heart was gripped with terror, I know he needs opportunities like this one to know he can always run back home and be accepted even when he hears that fear and upset in my voice.

Disrespectful Expectations

Several weeks ago, a friend told me this story about an interaction between her tween son and her mother. Since many of us are gearing up for big family events tomorrow, this topic is something worth thinking about. My friend, a 30-something-year-old Black mother of two in Texas, had this to say:

So today she apparently asked my 12 yr old if he could help her get 2 gallons of water from her car and he said no. She came to snitch and I’m sure was trying to embarrass him and I just said “I’ll help you.” He seemed annoyed she interrupted our conversation to tell me that. My family has no respect for children. I honestly assumed he didn’t feel like it. He had just gotten home and rode his bike from school today and he was getting his snack together. I wouldn’t want to stop preparing food to get water either when it can wait. It wasn’t perishable food she was asking for help with but it honestly didn’t matter to me. I teach them ‘you can always ask but sometimes the answer is no.’

She explained further that there is some background between her son and her mother. It seems she oversteps her bounds and tries to impose her ideology on the children. My friend’s son receives her actions as judgmental. When she asked “Do you want to help me with something?” he answered literally “No” because he was busy.

I can almost see the pearl-clutching! I come from a very Southern, very authoritarian background where adults owned all rights to the labor of children and children had no right to refuse. It was considered the height of rudeness and deserving of quite a spanking. I’ll grant that a young boy who had the strength to ride his bike all the way home from school surely has the strength to go outside to grab a couple gallons of water. Plus, it’s perceived as rude not to be considerate of an elderly relative’s wishes.

Before we had our children, Peaceful Dad and I created family guidelines, and one of those guidelines is “We always choose to help.” We teach our children that we are the heart and hands of Christ to our world. We help out of love. Not obligation. And never because someone wants to assert a flawed belief that my children should be subordinate. I don’t entertain discussing my kids negatively like this grandmother did, no matter who the adult is. I will always ask the adult to speak directly to my child if there’s been a problem. I can be there for moral support, but my child needs to be part of the conversation.

Had this scenario happened in my house, I probably would have broached the topic with my son to understand his perspective while affirming that no one is obligated to help anyone. I would want my son to know that there are relationship consequences for refusing a request for help, particularly since there exists a social expectation that children are to serve adults. This is something children need to be aware of, and it’s something worth discussing as we guide our children through the trials of childism.

Her entitlement was completely inappropriate. No one has a right to anyone else’s labor. I imagine my friend’s son would have graciously agreed had his grandmother asked, “When you finish eating your snack, would mind helping me get some gallons of water out of my car?” So, let’s flip this around. Is it not also rude of an adult, knowing this child was tired and hungry, to demand assistance with a non-urgent matter while the child is in the middle of making himself something to help him recover from his long day and his long ride? Could the request not have been made in a more understanding and compassionate way wherein both of their needs could have been met?

The trouble here is that, for many adults, the outcome isn’t as important as the interaction. They say they like seeing kind, cooperative, and respectful children, but what they really expect is deference and obedience.

That’s childism!

Rudeness is a matter of perception. In this case, the requester ultimately got the help she was requesting, so the problem was solved. I don’t want to suggest that kids be encouraged to break social “rules” for the sake of being controversial. I think it’s important for children to be aware of expectations and cultural consequences. But, at the same time, we also need to be holding adults accountable for how they interact with kids, and we need to instill self-confidence and self-worth in our kids so that they know how to navigate social expectations with grace and wisdom.

If a child is uncomfortable with a request being made of them, we can be there to help guide the conversation. Otherwise, we can give kids room to work out their own relationships and support them in upholding boundaries… even with elderly relatives. And, even at big family events.

I asked my friend what had changed since her own childhood that caused her to support her son in his interaction with her mother. She said:

In the past I would have felt pressured into forcing him to do something he didn’t want to do. When my daughter came along I realized that I was raising my kids differently than I was raised and than the kids in my family were being raised. One day my grandma asked my 1 year old for a hug at easter and my nephew who was about 4 said she “don’t do hugs.” My granny said “I don’t care, come give me a hug girl!” It was right then that I was like “oh hell no!” She is not about to force herself onto my child and traumatize her and then leave me with the job of cleaning up. So I stopped her in that moment and said “we don’t force physical contact on people,” and I looked at my daughter and said “can you wave bye bye to granny?” And she didn’t do that either and I said “maybe next time” and shrugged it off. That’s when I started looking into ways to fend off my pushy relatives because I knew there would be more situations like these in the future.

I went from spanking my son to not believing it was necessary I hardly ever took my kids out during nap time or would leave when they got tired because they just slept better at home and to prevent putting them in situations where they were over tired and would act out. Long ago, I decided that just because something is the way we’ve always done it, that doesn’t mean it’s not wrong.

Just because something is the way we’ve always done it, that doesn’t mean it’s not wrong. That is an entire lesson right there on its own! We can teach our children how to say, “I’m busy right now, but I’ll be with you as soon as I finish.” We can foster relationships in our children’s lives that meet their needs and those of the adults they care about. When the challenge in a child’s life is a social expectation, let’s allow genuineness and honesty to win out. It’s ok for children to say “not now” or even “no” to adults. Unclutch those pearls!

So, how do you instill a sense of selflessness in your kids? How do you foster the development of a human who enjoys being helpful whenever possible? I’m sure there are many ways families are doing this every day (and I’d love to hear from you in the comments!) I’ll mention one of the ways that has been invaluable for my family. We include our children in our everyday lives. Sounds pretty simple, but it takes planning and patience. It can be difficult to allow kids to help in their own developmentally appropriate ways. It’s messy and time consuming, but it is wonderfully affirming for your child! If you’d like to try it out, the key is to resist the urge to do things for your children. Don’t take over. If you want to insert yourself into the activity, help out! Demonstrate by modeling what’s expected. Openly speak with your child about the expected outcome, step by step. Children don’t know the process to get to an end result until they learn it. For example, including children in putting laundry away might look something like this:

  • Parent invites the child to help
  • Child accepts
  • Parent quickly explains what’s about to happen – “We’re going to take the clothes out of this laundry basket, fold them neatly, put them back into the basket, and then put them into their drawers. I’ll help you!”
  • Parent demonstrates how to fold an item of clothing and hands some clothes to the child
  • Parent and child go through the steps together

Many children will likely not be able to fold to an adult’s expectation, be able to open drawers and sort, and the like. Some direction is helpful, but allowing the child to try and accepting their effort as is goes a long way to instilling a love of helping in a child. And, start young. Thank your infant for helping you pick up toys even if it becomes a game. There are so many ways to include and appreciate kids. You and your child will figure it out together.

Squaring Santa

Most people would agree that there’s nothing troubling about millions of adults working together to convince children – and only children – of a lie. However, if an adult did such a thing to an adult, it would be met with something less than delight. Is it an innocent tradition or an example of how pervasive and deep-seated childism really is? It’s worth a discussion at the very least.

Let me say at the start here that I am not judging what you do. I’m not suggesting we burn down modern-day Christmas into a heap of social justice-scented ashes. I do, however, wonder if we’ve thoroughly thought this through and if, maybe, there’s a better option.

Childism, A Graphic Explanation

The Jolly Man in Red

Our favorite jolly man in red arrived in New York for the first time by way of Dutch immigrants in the late 1700s. It wasn’t until the mid-1800s that Christmas became a big shopping holiday, and Santa got a big boost. He was, after all, the face of Christmas! Around that time, in 1823, minister Clement Clarke Moore wrote “An Account of a Visit from St. Nicholas” in which Santa was conceptualized as a magical man who flew from house to house in a reindeer-drawn sleigh. Years later, in 1881, Thomas Nast, a political cartoonist, drew his vision of Santa based on Moore’s poem. His drawing of a man with white beard, red suit, North Pole workshop with elves, and lovely wife Mrs. Claus, solidified our national image of the portly, jolly fellow. For all intents and purposes, Santa Claus is only 196 years old, which is fairly recent considering the expanse of human history. His story was written when my great-great-great-grandparents were children.

The Real Santa Claus

As you may already know, Santa Claus is the modern incarnation of a real man, Nicholas of Myra. He was born in the 3rd century and grew up to become a bishop. Because of his faith, Nicholas was arrested and imprisoned by Roman Emperor Diocletian who had a terrifying reputation for persecuting Christians. In fact, he imprisoned so many Christians that the prisons could no longer accept criminals for a time.

Nicholas, now famously, threw bags of gold into the home of a poor nobleman who couldn’t afford the dowries his daughters required in order to be married. Although the act was done is secret, the nobleman found him out and anonymous gifts began to be attributed to Bishop Nicholas. Legend tells that the gold landed in stockings or shoes that were left by the fire to dry. This is where our custom of stockings derives.

How My Family Honors Saint Nicholas

Since we are Orthodox Christians, we have a special feast day during which we honor St. Nicholas: December 6th (which is December 19th on the Gregorian calendar). In my family, this is the day our children receive their stockings. Prior to St. Nicholas Day, we choose a family service activity to do together in reflection of the good works done by St. Nicholas in his day. We also read a book about St. Nicholas and his works on the evening of December 5th, and we choose toys to donate for other children to enjoy.

On St. Nicholas Day eve, the children receive their stockings! Each year, their stockings contain:

  • Money (for their savings accounts): Representing the money St. Nicholas threw into the window of a poor nobleman’s house.
  • A Toy: Representing the toys St. Nicholas commissioned a toymaker to make for children whose families couldn’t afford any.
  • A Prayer Related Gift: Representing the saint’s devotion to God.
  • A Treat: Representing the food he would give to people who were hungry; including a candy cane to represent his staff.
  • Clothing: Representing the clothes St. Nicholas gave to people who couldn’t afford any.

We do not participate in the modern myth of Santa Claus, because we already celebrate the real man! Our children aren’t old enough to spill the beans to other children, so to speak, but our plan is to explain to them that other families have traditions they hold dear, and we respect those traditions out of care for our family and friends. We will also tell them all about St. Nicholas and encourage them to tell their friends about all the wonderful things he did. If they are pressed to tell if they believe in Santa Claus, they will be able to say “Yes, I believe in St. Nicholas!” and leave it at that.

I recognize that other parents, including Peaceful Parents, enjoy the Santa Claus tradition. My intention is not to be abrasive or cruel, so while I want to encourage people to think through how the tradition may impact kids, I do not advocate purposely interfering with how other families celebrate Christmas.

Addressing the Childism in the Myth

Why do we not view the Santa Claus myth as childist? I ask to generate contemplation; not to judge. Here are some of the reasons that gave me pause when Peaceful Dad and I considered how we would handle Santa.

  • If it looks like a lie and behaves like a lie, it’s probably a lie. It’s a culturally acceptable one, but it’s a lie nonetheless and we consider lies coming from our kids to be unacceptable. It’s a double-standard.
  • Santa Claus is used in popular culture to manipulate children into “being good.” Even if families don’t do this themselves, their children are still going to be exposed to this mentality outside of their homes.
  • Children are often heartbroken and embarrassed when they learn the truth.
  • Caring parents have been compelled to manufacture even more lies to explain away the Santa myth in a less destructive way.
  • When parents talk about when and whether they should tell their children the truth about Santa, invariably, their decisions are based at least in part on how the parents feel about this developmental milestone. It’s not really about the kids.
  • Lying about Santa isn’t the only way to engender the Christmas Spirit.
  • Bonus: Santa rose to fame as a result of the commercialization of Christmas. The modern image of Santa was first used to sell a cartoonist’s work and then used to sell Christmas products in the 19th century stores. Not exactly the pure Christmas tradition we like to think about.

As a Peaceful Parent, will you take all of this into consideration? What are some other ways we can include Santa Claus at Christmastime that don’t involve culturally-encouraged deception?

Fostering Competent Eating

As someone who has struggled with my weight my entire adult life, this post is really important to me. I tried all sorts of diets and ended up losing 150+ pounds on a paleo/primal diet alongside improved control over my thyroid function. At the time, I thought it was amazing. I mean, who doesn’t want to lose weight?! Since then, I’ve had two children and nursed for a collective total of 4+ years, and it shows. My body is very different than it was before kids. I prayed for years for God to take my appetite away completely. Looking back, wow, what a request! “Dear Lord, please remove one of the basic functions that allows me to live.” It’s incredibly sad, really.

At the end of last year, I stumbled upon an answer I wasn’t expecting: Intuitive Eating (IE). If you haven’t heard of it, we’ll be going over it in this post. IE has changed my life. I’m happier and healthier without losing a single pound.

If you’re ready learn the secrets of raising children who have a great relationship with food, healthy bodies, and happy minds, read on!

Navigation

Why Post About Nutrition
Fatphobia
An Alternative to Traditional Food Rules
Ellyn Satter Institute
What is Normal Eating?
Division of Responsibility
The Key to Getting Your Kids to Try New Foods
Mealtime Basics
Nutrients and Forbidden Foods
In Our House
Bonus: Simple Sweet Snack Recipe

Why Post About Nutrition?

Not only am I not a nutritionist, but I’m also a superfat woman who dieted my way up to this point and has no intention of trying ever again to force my body to lose weight. I spent years losing and gaining the same weight and wrecking my metabolism as a result. I even had to have emergency gallbladder surgery due to my wild weight loss efforts. So, why listen to me at all?

Well, I’m posting about nutrition with the goals of interrupting fatphobia in the lives of children, eliminating excessive rules around food, quieting food moralizing, and allowing kids’ bodies to become the natural size they’re meant to be without adult intervention. And, I’m pointing to the collective work of thousands of nutritionists and nutrition scientists in the process. As a peaceful parent, I believe children must have autonomy over their bodies, including when they engage in the most basic act of eating.

Fatphobia

Fatphobia is fear and/or disgust toward fatness and fat people. Both thin and fat people experience harmful shaming. We can’t seem to get away from shame as a culture. However, the entire system is stacked against fat people in a way that thin people typically don’t experience.

So, why should you care about any of this as a peaceful parent? Well…

  1. Fatphobia starts as early as 3-years-old.
  2. Fatphobia is racist.
  3. Fatphobia is deadly.
  4. Fear of weight gain fuels eating disorders.
  5. Weight stigma reduces motivation to move and exercise and increases motivation to eat more.
  6. Fatphobia is so extreme and pervasive that people would rather be normal weight with heart disease or one leg amputated than be fat. It’s an actual study.
  7. Fatphobia leads to extreme discrimination such as prejudice on the job.
  8. Fat people receive poor medical care.
  9. If not for fatphobia, more people would understand that health is so much broader than weight.
  10. Obesity may not be as big a deal as you’ve been led to believe.

Oh, by the way, the Body Mass Index (BMI) was never intended to be individually diagnostic. The person who developed what would come to be known as the BMI was a social science statistician who was curious about what the “average” person looked like weight-wise in his day, so he measured a bunch of white people and created average weight/height ranges. BMI is descriptive of a population. It was not, and cannot be, prescriptive. It can’t tell you if you’re healthy. Applied accurately, BMI should be reassessed to see what the average person looks like today instead of trying to cram us all into arbitrary weight ranges.

It’s ok to be fat. It’s ok to be slim. It’s ok to be everything in between. What’s not ok is to dictate to children what size their bodies should be. Doing so hurts kids. Particularly when it comes to children of size, weight stigma at home combined with systemic fatphobia leads to things like binge eating, social isolation, refusal of medical care, and other barriers to health. Bottom line, stop worrying about your kids’ weight and, instead, make non-weight related changes to your family’s lifestyle.

Rather than stressing over weight, try encouraging fun movement every day (and you should join in too!), adding in plant foods, going easy on alcohol, and avoiding tobacco products entirely. Doing just these four things will drastically increase your family’s lifespan and quality of life without weight loss or gain. More time with my kids? Yes please!

An Alternative to Traditional Food Rules

Intuitive Eating (IE) is an approach to human-centered nutrition that heals the physical and psychological impacts of dieting and diet culture. It is the ultimate anti-diet that guides our bodies back to the natural responses to hunger and satiety that we were born with. Substantial research informs this approach, so many Registered Dieticians are now working toward (or are already practicing with) IE certification. You may be able to find support in your area through the official IE website or here.

IE embraces the following ten principles:

  1. Reject the Diet Mentality
  2. Honor Your Hunger
  3. Make Peace with Food
  4. Challenge the Food Police
  5. Respect Your Fullness
  6. Discover the Satisfaction Factor
  7. Honor Your Feelings Without Using Food
  8. Respect Your Body
  9. Exercise – Feel the Difference
  10. Honor Your Health

Ultimately, IE can reacquaint adults with our internal systems of food management, and improve our mental health as we disengage from diet culture. For an in-depth beginner’s guide, I highly recommend Rachael Hartley’s Intuitive Eating 101. If you’re interested in a deeper dive, the Facebook group, Intuitive Eating for Beginners, may be just what you need.

Intuitive Eating is a huge topic with lots of blogs devoted strictly to its practice. For my purposes, I’m looking to key in on childhood nutrition to help parents and caregivers make the switch to an approach to nutrition that also strengthens the relationship between child and adult.

Ellyn Satter Institute

The fact of the matter is that children cannot truly practice Intuitive Eating, at least not in the sense that adults can. Children do not manage food purchases, meals, or schedules. As such, the adults in their lives are responsible for guiding them toward Intuitive Eating by fostering their natural inclinations. That’s where Ellyn Satter comes in.

Satter is a Registered Dietitian and therapist specializing in eating disorders with more than 40 years of experience in her field. Her work has provided us a complete picture of how to take children from birth to adulthood without smothering their natural ability to regulate food intake, which is something many adults in the U.S. have lost to dieting.

The Ellyn Satter Institute was established to advance eating competence via theoretically grounded, evidence based, and clinically effective practices. The Institute publishes nutrition guidance, trains professionals, and connects mentors with families.

What is Normal Eating?

According to Satter,

  • Normal eating is eating competence. It is going to the table hungry and eating until you are satisfied.
  • It is being able to choose food you enjoy and eat it and truly get enough of it – not just stop eating because you think you should.
  • Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food.
  • Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good.
  • Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way.
  • It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful.
  • Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more.
  • Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.
  • In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food and your feelings.

Division of Responsibility

The key to Satter’s methods with children is Division of Responsibility, which refers to which family member is responsibility for which choices around food. This is where it all begins.

Traditionally, parents have made all the choices. We choose what’s going to be prepared, and when and where we’re going to eat. We also tend to hound our kids to eat.

“Try a few bites and you don’t have to eat anymore.”

“Finish your vegetables and you’ll get a treat.”

“Think of all the starving children who would love to have what you have!”

None of these statements honors the autonomy of the child. What I see is coercion in the first, bribing/rewards in the second, and shaming in the third. What’s a peaceful parent to do?? Here’s what!

So, you choose when and where to eat, you put the food on the plate, and then you trust your child to eat the items they want in the amounts they want. If they don’t try it all, that’s ok.

The Key to Getting Your Kids to Try New Foods

Exposure. That’s it. A 2016 study found that exposure alone drastically increases the likelihood that infants will eat a variety of vegetables for the greater part of their childhood. The same is true no matter the age of the child. The more often you introduce a food, the more likely your child will be to eat it.

I always try to make sure to include at least one item in each meal that I know my children will eat, and sometimes, that’s all they eat. It may be a piece of bread or a bowl of beans or miso soup. I don’t stress it, because I know they nibble on lots of nutrient-dense foods throughout the week, and I keep exposing them to common foods that they won’t yet eat. This hands-off approach paired with the obvious enjoyment they see in my husband and me while we eat means we will have adventurous foodies in time.

The less you intervene, the more likely kids are to try new foods in the future. You can even make a game of it between mealtimes by offering small amounts of new foods for them to taste and critique. You can also improve the likelihood your child will try a new food by inviting them to participate in the process of preparing and cooking the food. Many nights, I bring BB into the kitchen with me to help cut food (hand over hand as he’s only 4), stir pots, taste raw vegetables, and season our food.

Mealtime Basics

Satter recommends structured meals and sit-down snacks. It’s important to prepare what you enjoy and include foods you know your children will like. You need not prepare separate meals for different family members. One meal eaten together is the best way to encourage eating competence in children. Families meals are crucial to the long-term physical and mental health of kids. Check out the research behind the value of family meals here. When you eat together, try to minimize distractions by creating a food only zone. No homework. No electronics. No pets. Just people, the food in front of them, and the full-bodied conversations that can happen in an intimate social space.

Consistent, expected meals plus scheduled snacks help children better manage their hunger and satiety. Plan three meals a day, making sure not to skip any. If your child isn’t particularly hungry at a given meal, that’s ok. Accept whatever form of “no thank you” your child can communicate, if they aren’t ready to eat. A snack time will come along shortly and provide the energy your child needs. Remember, your child is the only person who knows how much or how little their body needs to eat. This is not information you are privy to.

Snacks are meals too, just smaller. Snacks should be available at planned times and include protein, fat, and carbohydrate to provide sustained satisfaction. Encourage your child to eat until they feel good and then head off to do another activity. Snacks should be timed to ensure that your child has a chance to get hungry for the next regular meal.

Nutrients and Forbidden Foods

One of the hardest ideas to release as a new Intuitive Eater is the idea that some foods are “better” than others. Go ahead and put that out of your mind. Food has no morality. On microscopic level, foods have varying levels of macro and micronutrients. Some foods are more nutrient dense than others. No single food has all the nutrients we need to thrive though. We need variety. That variety can include brussels sprouts, french fries, breakfast cereal, steak, oatmeal, apples, cabbage, cookies, quinoa, eggs, almond butter, cheese, candy, or any combination of any foods you enjoy.

Check out this fantastic talk by Tracy Brown, RD regarding food choice:

Offering your child a variety of foods at each meal that cover proteins, fats, and carbohydrates without judging them on what they actually eat is healthy. Since children have limited room in their stomachs for food, it makes sense to try to pack in nutrients, which is why things like whole, plant-based foods work so well. They pack a punch in less space. Win-win for little tummies.

BUT, no food can be off limits. If you restrict your kids’ food options, you risk creating a situation where your child will be compelled to lose control when a forbidden food becomes available. Your goal here is to encourage a relaxed relationship between your child and their food. Satter recommends:

  • Regularly including fatty, salty foods like chips and fries at meals, so your child will learn how to eat their fill without going wild.
  • Often, putting a single portion of sweets/desserts at each person’s place and giving your child the option of eating their treat before, during, or after the meal.
  • And, occasionally giving your child unlimited access to sweets during snack time. For instance, set a plate of cookies on the table and let your child go to town. These opportunities help children exercise their hunger and satiety cues in the presence of highly desirable food (something adults seriously struggle to do). An excellent example of this practice is the wise management of Halloween candy.

Break free from diet culture and guard your mind against fatphobia, so you and your family can experience the freedom and fun of Intuitive Eating! It’s so much easier and more fulfilling to raise a child to eat competently through self-regulation than it is to constantly hound kids about their food choices and their appearance. And, what is a peaceful parent but a guide who helps children find their own way in this world?

In Our House

It’s pretty wild around here. We recently switched to booster pads instead of booster seats/high chairs with straps, so the kids have freedom of movement. We’re practicing good table manners by modeling and coaching, but no one gets in trouble for getting up if they feel they can’t comfortably sit still. We just wait a moment and encourage the child back into their seat.

We follow Satter’s model as closely as we can, but we have to be flexible to accomodate eventualities… including children who don’t know or care about Satter at all. Beyond the food, the most important aspect of our approach, for me, is that we have banned moralizing at the table. We don’t comment on what our kids are (or aren’t) eating. We simply remind them to eat if they become distracted. When it seems they’re slowing down and starting to play with the food, we’ll ask “all done?” We don’t compare one child to the other either. Each child has complete authority over their own plates.

When they ask for food that’s either not on the menu or we don’t have at all, we don’t tell them they can’t have it because it’s bad for them. We say we’ll add it to the menu for the following week. We look for ways to say yes to their blossoming culinary palates while working to establish consistent routines and schedules that help them get in touch with their hunger and satiety.

Our practice of non-judgment around nutrition has resulted in young children who eat a wide variety of food and will try new foods without any prompting. Sometimes, I marvel at them and am surprised by the things they enjoy, but I remain calm and positive during mealtimes. Nothing to see here. We’re just enjoying our food!

Bonus: Simple Sweet Snack Recipe

Check out this low fuss recipe for homemade granola!

Ingredients

  • 8 cups of rolled (old fashioned) oats
  • 1 cup brown sugar
  • 3/4 cup sliced almonds
  • 1/2 cup Just Foods Hemp Protein
  • 1/4 cup Badia Health Seeds, Trilogy, Whole
  • 1 tbsp cinnamon
  • 2 tsp salt
  • 3 whole eggs, whisked (or flax eggs for a vegan option)
  • 1 cup canola oil
  • 2 tsp vanilla extract

Directions

Mix together dry ingredients in a large bowl, using clean hands to break everything down together.

Pour wet ingredients into the bowl and mix well. Again, I like to use my hands to make sure the dry ingredients get completely saturated. It’s messy but hands are your best tool here.

Smooth into a large baking pan lined with parchment paper and bake at 250F for about an hour or until the mixture browns and starts smelling a bit like oatmeal cookies.

Allow the granola to cool completely before storing. I store mine in a large rubbermaid cereal container. This recipe makes pretty chunky granola, so you may need to break large chunks up a bit.

I make a batch most weekends and we nibble on it throughout the week.

Are You Saying I’m a Bad Parent?

No, I am not. I wouldn’t. It’s not even the way I think about disagreements I have with other parents. I’ve gotten some version of this question over the years I’ve been talking about Peaceful Parenting. Our culture is so binary. Either you’re a Peaceful Parent or you’re a bad parent. Either you do things the way I do or you’re a sh*t parent. That’s one of those titles that I really despise. We’re good at calling each other names, and wow, the names I’ve been called have been creative. What we’re not so great at is bearing with each other. Coming alongside other parents and saying, “I can see that you’re having a hard time. Do you have the bandwidth to hear about an alternative?” Or, simply keeping our mouths shut and being a listening ear when that’s needed.

I write to be a voice for kids, a society challenger, and a peer resource for parents. You may feel convicted by what I post, just like I was when I started reading about Peaceful Parenting, but I am not here to judge you as a person or as a parent. I’m not a fluff piece though. I will debate anyone over the evidence pointing to Peaceful Parenting being the highest quality approach to child rearing, because it’s important to me and it’s a special interest of mine. I don’t intend to harm anyone by appearing dogged in my discussions, but I can be pretty intense. Behind it all is my compassion for kids and for their parents.

Even within the Peaceful Parenting community, we don’t all agree. I’m sure some Peaceful Parents will happen upon my page and cringe at some of the things I say, because I struggle not to give into my authoritarian side. I know that comes through in my anecdotes. I’m ok with it though, because just like all of you, I too am on this journey. I don’t know what’s to come. I’m relying on extensive reading and a lot of prayer myself.

I’m no expert, but I do have a lot of knowledge knocking around in my head. I want everyone to have the tools and resources they need to have the most fulfilling parenting experience they can. That goes for people who always wanted kids, people who never wanted kids but are glad they have them, people who don’t actually want to be parents now that they have kids, people who work with kids, and so on. If you’re coming to my table, I’m going to feed and include you.

One Cure for Whining

Want to know something pretty incredible about whining? Researchers have posited that it may actually be an evolution of crying at a time when children “switch from primarily mothers to greater care from other caregivers.” That means whining serves an evolutionary purpose in communication between young children and adults. Kids who whine when resources are limited tend to be heard and that means they tend to survive. Pretty clever, huh? But, stressful nonetheless.

I know my title mentions a “cure” for whining, but in reality, whining is good as far as I’m concerned. It signals that a child is emotional, under or over-stimulated, or just plain done. That kind of information can help you be an even more responsive parent. Whining tells you there’s a need waiting to be met and, if you can pinpoint what it is, you can avoid a meltdown. Before you do anything else, make sure your child’s basic needs are squared away. Hunger? Thirst? Discomfort? Tiredness? Sometimes, all it takes is addressing the underlying situation to resolve the cause of the whining.

However, when that’s not possible or when you can’t determine what the issue is, there’s another trick you can keep up your sleeve. The surprisingly powerful “First/Then” statement. It works in just about every context. Let’s say your child wants to go outside to play, but there are toys everywhere. You might say, “Not until you clean up.” That’s a pretty amorphous statement when you think about it. “Not until you clean up.” There’s no direction. No time frame. No, point a to point b.

Back in the late 1800s, Pierre Janet – a French psychologist who specialized in dissociation and traumatic memory – set out to explore the phenomenon wherein we feel like time passes more quickly as we get older. He came up with the “ratio theory” which suggests that the smaller proportion of our lives that remains, the more quickly we feel we’re hurtling toward the end. There are other theories about the phenomenon, some say it’s memory, others our biological clock. Whatever the truth is, one thing is for sure. Time moves at a snail’s pace for children. We can be sensitive to that even as we establish limits for our kids.

Back to cleaning up those toys. Giving children more of a clear directive without attempting to control their every move often helps motivate them and reduces their need to whine in order to be heard. In our scenario, you might consider saying, “First, I need for you to pick up your toys and put them where they belong. Then, you’re welcome to go outside and play until the sun goes down.” You’ve given your child a task list to check off, time-related landmarks, and the power to choose how long to do the task you’ve given. And, if you really want to level up on your Peaceful Parenting, offer to help your child clean up! The very best cure for whining is to meet your child needs.

The Complete Layperson’s Guide to Melatonin for Kids

Disclaimer: Nothing stated in this post should be construed as an alternative to diagnosis and treatment by a medical professional. I am not qualified to provide medical advice.


If you’re anything like me, you’ve heard of the near miraculous wonders of melatonin supplementation. You may have also heard some of the not so great effects. So, let’s get down to the truth with our dear friend, science.

Use the Navigation links below to jump to sections of interest or read through for all the knowledge.

Navigation

What is Melatonin and What Does it Do?

Dosage

Clinical Guidelines

Possible Safety Issues

The Studies

Assessment of the Evidence

Promoting Better Sleep

The Bottom Line

What is Melatonin and What Does It Do?

Melatonin (5-methoxy-N-acetyltryptamine) is a fat-soluble hormone that confers widespread health benefits and is produced in the pineal gland of the brain as well as by the retina of the eye and by the gastrointestinal tract. Production of endogenous (meaning made by the body) melatonin is triggered by darkness, and it typically peaks between 11 PM and 3 AM. Our bodies’ ability to produce melatonin decreases with age.

Melatonin “plays the role of a universal endogenous synchronizer” which, in addition to helping to maintain the wake-sleep cycle, also influences hemostasis, glucose homeostasis, phosphocalcic metabolism, blood pressure, and antioxidant defenses. In other words, melatonin stabilizes the circadian rhythms in the body, thereby impacting the body’s ability to coagulate blood, maintain normal blood glucose levels and blood pressure, metabolize phosphate and calcium for functions such as bone mineralization, and defend against the damage caused by free radicals.

Exogenous (meaning man-made) melatonin supplements can be made one of two ways. Either from the pineal glands of animals, which can be dangerous due to the potential for viral contamination, or as a synthetic product that is manufactured in a lab. Most commercial supplements are synthetic. Plant-based supplements are in the pipeline and melatonin naturally exists in the foods we eat as forms of it are produced by living organisms from animals to bacteria to algae to plants and beyond.

Melatonin is now being studied for other applications such as fertility support, reduction of the symptoms of endometriosis and PCOS, treatment of certain cancers, treatment of osteoporosis treatment as it may increase bone density, immune support, pain management, improvement in breathing for people with COPD, treatment for Ebola, protection against neurodegenerative diseases, prevention of Type 2 diabetes, and more. While exogenous melatonin appears to be a promising component of treatments across a variety of conditions, little is known about its dose-response relationships.

Dosage

Back in 1994, Dr. Richard Wurtman, professor of neuroscience at MIT, led a team that confirmed where melatonin was produced in the body and how it functioned. His team discovered that a dose of 0.3 milligrams of melatonin helped older adults fall asleep faster and get back to sleep if they woke up in the night. However, researchers also discovered that commercial melatonin contained 10 times the effective dose, which, when taken regularly, ultimately overwhelms melatonin receptors in the brain, causing them to become unresponsive. At the time, he warned that “People should not self-medicate with melatonin.”

Studies to date have utilized pharmaceutical grade melatonin that is strictly regulated and certified to contain the ingredients in the appropriate proportions as labeled. Under these controlled conditions, substantive support exists for the presence of a plateau effect in adults with doses higher than 0.3 milligrams; the maximum effect being achieved at low doses with decreasing effectiveness in doses exceeding 1 milligram. In addition, there is some evidence that exogenous melatonin requires dosage over the course of a few days to achieve detectible effectiveness, and that it may increase in effectiveness over the course of time until the benefits plateau. The half-life of melatonin is less than one hour, which means that its usefulness from a given dose is short-lived. Some pharmaceutical grade melatonin medications have extended-release formulations to help improve the usefulness of the drug. It is unclear whether or not single doses of melatonin are effective.

High doses of exogenous melatonin have been demonstrated to desensitize receptors in the brain, thereby eventually making supplementation ineffective. However, without clear guidelines on appropriate dosing, the level at which overdose occurs remains unknown. Unfortunately, a 2017 analysis out of Canada found egregious mislabeling of melatonin supplements with counts varying from −83% to +478% of labeled melatonin. Chewable tablets suffered from the highest variability with one tablet containing nearly 9 milligrams of melatonin when it was labeled as 1.5 milligrams. Capsules suffered the greatest variability among lots. And, liquids had the greatest levels of stability, though they too were highly inconsistent. Oral and sublingual tablets with few ingredients proved the least variable of all the options. However, many of the supplements also contained impurities, including serotonin which has known effects and should not be taken by accident.

There is no known safe dose or dosing frequency for children.

Clinical Guidelines

In 2017, a task force from the American Academy of Sleep Medicine conducted a systematic review of the available literature to identify randomized controlled trials. Based on the evidence, this task force established recommendations for use by medical professionals. The task force listed 14 types of sleep aids and noted whether they were recommended for use or not. They advised clinicians not to use melatonin as a treatment for sleep onset and sleep maintenance insomnia.

Melatonin supplements may be contraindicated if a person has:

  • An allergy to the ingredients
  • Diabetes
  • Depression
  • Hemophilia
  • High or Low Blood Pressure
  • Epilepsy or Other Seizure Disorder
  • Conditions requiring Immunosuppressants
  • An Autoimmune Condition

Or is using:

  • Blood Thinners
  • Sedatives or Tranquilizers

Also, it is unknown whether melatonin supplements are safe during pregnancy or breastfeeding. High doses of melatonin may present fertility problems by affecting ovulation.

Possible Safety Issues

In 2015, Dr. David Kennaway conducted a review of the evidence for melatonin use in children, which was published in the Australian Journal of Paediatrics and Child Health. He determined that melatonin can produce “small advances in the timing of sleep onset” in both adults and children, but that there have “no appropriate studies to show that melatonin is safe in the long term for children or adults.” Use in children is always an off-label application of this hormone. He noted that, as a hormone, melatonin directly impacts the endocrine system and that long-term use may result in future “endocrine or other abnormalities.” He recommended that melatonin be prescribed only following a “biochemical diagnosis of an underlying sleep timing abnormality and after full disclosure to the carers of information about the known actions of melatonin on reproductive and other systems.”

In the United Stated, melatonin is considered a supplement. Therefore, it is generally unregulated by the Food and Drug Administration (FDA) and consumers have no guarantees regarding the safety of the commercial melatonin they purchase.

The Studies

When I began to seek out studies, I discovered thousands of papers that mentioned the term “melatonin.” In order to refine the list, I began by excluding studies published before 2009 and including only studies conducted on humans and written in/translated into English. From this list, I sorted by relevance and chose 175 to skim for abstracts. Then, I selected 80 to read in full, which resulted in a final resource list of 23 papers having targeted relevance. These studies involve research in countries around the world. I have grouped them by year for ease in assessing the progression of the research and recommendations.

2009

The effect of prolonged-release melatonin on sleep measures and psychomotor performance in elderly patients with insomnia
https://www.ncbi.nlm.nih.gov/pubmed/19584739
doi: 10.1097/YIC.0b013e32832e9b08

OBJECTIVE: To investigate the effects of prolonged-release melatonin 2 mg (PRM) on sleep and subsequent daytime psychomotor performance in patients aged 55 years and older with primary insomnia.

FINDINGS: By the end of the double-blind treatment, the PRM group had significantly shorter sleep onset latency and scored significantly better on a psychomotor performance test than the placebo group.

2011

Melatonin for disordered sleep in individuals with autism spectrum disorders: systematic review and discussion
https://www.ncbi.nlm.nih.gov/pubmed/21393033
doi: 10.1016/j.smrv.2011.02.001

OBJECTIVE: To provide a systematic review of efficacy and safety of exogenous melatonin for treating disordered sleep in individuals with ASD.

FINDINGS: The literature supports the existence of a beneficial effect of melatonin on sleep in individuals with ASD, with only few and minor side effects. However, these conclusions cannot yet be regarded as evidence-based. Randomized controlled trials and long-term follow-up data are still lacking.

Prolonged release melatonin in the treatment of primary insomnia: evaluation of the age cut-off for short- and long-term response
https://www.ncbi.nlm.nih.gov/pubmed/21091391
doi: 10.1185/03007995.2010.537317

OBJECTIVE: To evaluate the age cut-off from a previous study for response to PRM and the long-term maintenance of efficacy and safety by looking at the total cohort (age 18-80).

FINDINGS: At 3 weeks, significant differences in favor of PRM vs placebo were found for the 55-80 year population but not the 18-80 year cut-off which included younger patients. Other variables improved significantly with PRM in the 18-80 year population more so than in the 55-80 year age group. No withdrawal symptoms or rebound insomnia were detected.

2012

Melatonin for sleep in children with autism: a controlled trial examining dose, tolerability, and outcomes
https://www.ncbi.nlm.nih.gov/pubmed/22160300
doi: 10.1007/s10803-011-1418-3

OBJECTIVE: To assess dose-response, tolerability, safety, feasibility of collecting actigraphy data, and ability of outcome measures to detect change during 14-week intervention on children aged 3-10 years with a clinical diagnosis of an autism spectrum disorder who were free of psychotropic medications and whose parents reported sleep onset delay of 30 minutes or longer on three or more nights per week.

FINDINGS: Researchers documented an improvement in sleep latency with melatonin treatment. Because the study criteria were designed to enroll children with sleep-onset delay, they could not definitively comment on the effects of melatonin on sleep duration or night wakings.

2014

Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature
https://www.ncbi.nlm.nih.gov/pubmed/24802882
doi: 10.1007/s40266-014-0178-0

OBJECTIVE: To define the optimal dosage of exogenous melatonin administration in disorders related to altered melatonin levels in older adults aged 55 years and above by determining the dose-response effect of exogenous administered melatonin on endogenous levels.

FINDINGS: Based on a systematic review of 16 articles from 1980 to 2013, nine of which were randomized controlled trials, the best applicable dosage for melatonin for older adults still cannot be adequately determined, as endogenous melatonin levels are subject to altered pharmacokinetics and -dynamics. This causes the risk of prolonged and elevated endogenous melatonin levels after exogenous melatonin administration in older adults. The researchers advise the use of the lowest possible oral dose of immediate-release formulation melatonin to best mimic the normal physiological circadian rhythm of melatonin and to avoid prolonged, supra-physiological blood levels.

The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature
https://www.ncbi.nlm.nih.gov/pubmed/25380732
doi: 10.1186/1475-2891-13-106

OBJECTIVE: To critically assess the available peer-reviewed literature on the use of melatonin in military service members and in healthy subjects to determine whether melatonin might be useful in military populations.

FINDINGS: The use of melatonin by healthy adults shows promise to prevent phase shifts from jet lag and improvements in insomnia, but to a limited extent. For the initiation of sleep and sleep efficacy, the data cannot yet confirm a positive benefit.

Melatonin in children with autism spectrum disorders: endogenous and pharmacokinetic profiles in relation to sleep
https://www.ncbi.nlm.nih.gov/pubmed/24752680
doi: 10.1007/s10803-014-2123-9

OBJECTIVE: To describe overnight endogenous and PK melatonin profiles in children aged 3-8 years with ASD participating in open-label trial of melatonin for sleep onset insomnia.

FINDINGS: In children with ASD and insomnia responsive to treatment with supplemental melatonin, evidence exists for normal endogenous melatonin profiles. Furthermore, despite a relatively short duration of action of supplemental melatonin, night wakings improved in most children with treatment. This raises the possibility that supplemental melatonin may be influencing sleep onset delay and night wakings by mechnanisms other than simply replacing melatonin.

2015

The effect of melatonin treatment on postural stability, muscle strength, and quality of life and sleep in postmenopausal women: a randomized controlled trial
https://www.ncbi.nlm.nih.gov/pubmed/26424587
doi: 10.1186/s12937-015-0093-1

OBJECTIVE: To document the safety of melatonin in postmenopausal women given evidence from previous studies that suggests a protective role of melatonin against osteoporosis through an increase of bone mineral density.

FINDINGS: Melatonin in a daily dose of 1 or 3 mg is safe to use in postmenopausal women with osteopenia. There is no long term hangover effect causing a reduction in balance- and muscle function or quality of life. In women with poor quality of sleep, small doses of melatonin trended towards improving quality of sleep.

Current role of melatonin in pediatric neurology: clinical recommendations
https://www.ncbi.nlm.nih.gov/pubmed/25553845
doi: 10.1016/j.ejpn.2014.12.007

OBJECTIVE: To establish a consensus on the roles of melatonin in children and on treatment guidelines at a conference in Rome in 2014.

FINDINGS: So far, the best evidence for the indication of melatonin treatment in children is for insomnia caused by circadian rhythm sleep disorders. Because insomnia due to other situations and disorders, including bad sleep hygeine, ADHD/ADD, personality disorders and depression, can mimic insomnia caused by circadian rhythm sleep disorders, the diagnosis should only be made after careful clinical assessment and possibly measuring dim light melatonin onset (DLMO). Melatonin can be effective not only for primary sleep disorders but also for sleep disorders associated with several neurological conditions. Controlled studies on melatonin for sleep disturbance in children are needed since melatonin is very commonly prescribed in infants, children and adolescents, and there is a lack of certainty about dosing regimens. The dose of melatonin should be individualized according to multiple factors, including not only the severity and type of sleep problem, but also the associated neurological pathology.

Melatonin Treatment in Children with Developmental Disabilities
https://www.ncbi.nlm.nih.gov/pubmed/26055866
doi: 10.1016/j.jsmc.2015.02.008

OBJECTIVE: To provide a succinct summary to help inform clinical and research practices for children with developmental disabilities (i.e. children with unspecified developmental delays or cognitive impairments and specific disorders/syndromes including ASD, Smith-Magenis syndrom, Angleman’s syndrom, fragile X syndrom, Down syndrom, and Rett syndrome).

FINDINGS: Following a review of a number of studies and a meta-analysis by Braam and associates, researchers determined that melatonin treatment yields beneficial effects with minimal side effects. However, melatonin is not approved by the US Food an Drug Administration and no drug is approved for use in pediatric insomnia (as of the time of this study).

Potential safety issues in the use of the hormone melatonin in paediatrics
https://www.ncbi.nlm.nih.gov/pubmed/25643981
doi: 10.1111/jpc.12840

OBJECTIVE: To provide information on the documented actions and properties of melatonin outside its ability to alter sleep timing that have been widely ignored but which raise questions about the safety of its use in infants and adolescents.

FINDINGS: Melatonin is increasingly being prescribed off lable for children and adolescents for difficulty in initiating and maintaining sleep. There is extensive evidence from animal and human studies that melatonin acts on multiple physiological systems, including the reproductive, cardiovascula, immune, and metabolic systems. Long-term safety studies on children and adults are lacking. Prescription of melatonin to any child whether severely physically or neurologically disabled or developing normally should be considered only after the biochemical diagnosis of an underlying sleep timing abnormality and after full disclosure to the carers of information about the known actions of melatonin on reproductive and other systems and the disclosure that there is a lack of appropriate studies conducted on children. Should endocrine or other abnormalities appear in the future in children previously treated with melatonin, it will not be tenable to argue that were were surprised.

2016

The Safety of Melatonin in Humans
https://www.ncbi.nlm.nih.gov/pubmed/26692007
doi: 10.1007/s40261-015-0368-5

OBJECTIVE: To present and evaluate the literature concerning the possible adverse effects and safety of exogenous melatonin in humans and provide recommendations concerning the possible risks of melatonin use in specific patient groups.

FINDINGS: A substantial number of both animal and human studies document that short-term use of melatonin is safe, even in extreme doses. No studies indicate that exogenous melatonin possesses any serious adverse effects. Also, randomized clinical studies indicate that long-term administration only induces mild adverse effects comparable to placebo treatment. Due to a lack of human studies, pregnant and breastfeeding women should not take exogenous melatonin. Also, long-term safety of melatonin in children and adolescents requires further investigation.

Melatonin Supplementation for Children With Atopic Dermatitis and Sleep Disturbance: A Randomized Clinical Trial
https://www.ncbi.nlm.nih.gov/pubmed/26569624
doi: 10.1001/jamapediatrics.2015.3092

OBJECTIVE: To evaluate the effectiveness of melatonin supplementation for improving the sleep disturbance and severity of disease in children with AD.

FINDINGS: Sleep-onset latency shortened by 21.4 minutes after melatonin treatment compared with after placebo. Melatonin supplementation is a safe and effective way to improve the sleep-onset latency and disease severity in children with AD.

2017

Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders
https://www.ncbi.nlm.nih.gov/pubmed/28648359
doi: 10.1016/j.smrv.2016.06.005

OBJECTIVE: To assess the evidence base for the therapeutic effects of exogenous melatonin in treating primary sleep disorders.

FINDINGS: Results from the metaanalysis shoed the most convincing evidence for exogenous melatonin use was in reducing sleep onset latency in primary insomnia, delayed sleep phase syndrome, and regulating the sleep-wake patters in blind patients compared with placebo.

Melatonin Natural Health Products and Supplements: Presence of Serotonin and Significant Variability of Melatonin Content
http://jcsm.aasm.org/ViewAbstract.aspx?pid=30950&_ga=2.259319754.190833121.1571016443-900543218.1571016443
doi: 10.5664/jcsm.6462

OBJECTIVE: To quantify melatonin in 30 Canadian commercial supplements, comprising different brands and forms and screen supplements for the presence of serotonin.

FINDINGS: Melatonin content was found to range from -83% to +478% of the labeled content. Additionally, lot-to-lot variable within a particular product varied by as much as 465%. This variability did not appear to be correlated with manufacturer or product type. Furthermore, serotonin was identified in eight of the supplements at levels of 1 mg to 75 mg. Melatonin content did not meet label within a 10% margin of the label claim in more than 71% of supplements and an additional 26% were found to contain serotonin. It is important that clinicians and patients have confidence in the quality of supplements used in the treatment of sleep disorders. To address this, manufacturers require increased controls to ensure melatonin supplements meet both their label claim, and also are free from contaminants, such as serotonin.

2018

The use and misuse of exogenous melatonin in the treatment of sleep disorders
https://www.ncbi.nlm.nih.gov/pubmed/30148726
doi: 10.1097/MCP.0000000000000522

OBJECTIVE: To explore the evidence for using exogenous melatonin in the treatment of sleep disorders, both primary and secondary, in children and adults.

FINDINGS: There is evidence for the efficacy of melatonin in the management of insomnia and some intrinsic disorders of circadian rhythm in adults and children as well as in reducing sleep onset latency in jet-lag and shift work disorder in adults. Melatonin is used routinely in the treatment of rapid-eye movement sleep-behaviour disorder despite limited trial evidence. Increasingly, dual melatonin receptor agonists are being trialed in a variety of sleep disorders. Long-term adverse effects are currently not fully identified.

Sleep disorders during childhood: a practical review
https://www.ncbi.nlm.nih.gov/pubmed/29502303
doi: 10.1007/s00431-018-3116-z

OBJECTIVE: To discuss the normal sleep
development and needs in children, and we will provide an
overview of sleep disorders, based on the 3rd edition of the
International Classification of Sleep Disorders [ICSD-3].

FINDINGS: Melatonin is an effective, safe, and well-tolerated agent, particularly in cases of sleep-initiation insomnia caused by circadian factors. Several placebo-controlled studies of melatonin in adults and children (in some studies, as young as 3 years of age) showed that melatonin administered at bedtime reduces sleep-onset latency time and increases total sleep time.

An update on pharmacotherapy of autism spectrum disorder in children and adolescents
https://www.ncbi.nlm.nih.gov/pubmed/29693461
doi: 10.1080/09540261.2018.1458706

OBJECTIVE: To review pharmacological treatment options for children and adolescents with ASD, with emphasis on recently published studies since our previous published update. We focus on randomized double-blind placebo controlled (RDBPC) trials, with at least 10 subjects. We also discuss CAM treatment options used in children
with ASD.

FINDINGS: In addition to its effect on sleep, a few RDBPC trials have shown that melatonin can improve communication, rigidity, and anxiety in children with ASD.

Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review
https://www.ncbi.nlm.nih.gov/pubmed/30382936
doi: 10.3310/hta22600

OBJECTIVE: To assess the clinical effectiveness and safety of NHS-relevant pharmacological and non-pharmacological interventions to manage sleep disturbance in children and young people with NDs, who have non-respiratory sleep disturbance.

FINDINGS: It was not possible to draw conclusions about the effectiveness of non-pharmacological interventions for managing sleep disturbance, and although there was some benefit with melatonin the degree of benefit is uncertain. There is some evidence of benefit for melatonin compared with placebo, but the degree of benefit is uncertain. There are various types of non-pharmacological interventions for managing sleep disturbance; however, clinical and methodological heterogeneity, few RCTs, a lack of standardised outcome measures and risk of bias means that it is not possible to draw conclusions with regard to their effectiveness. Future work should include the development of a core outcome, further evaluation of the clinical effectiveness and cost-effectiveness of pharmacological and non-pharmacological interventions and research exploring the prevention of, and methods for identifying, sleep disturbance. Research mapping current practices and exploring families’ understanding of sleep disturbance and their experiences of obtaining help may facilitate service provision development.

Could long-term administration of melatonin to prepubertal children affect timing of puberty? A clinician’s perspective (2018)
https://www.dovepress.com/could-long-term-administration-of-melatonin-to-prepubertal-children-af-peer-reviewed-fulltext-article-NSS
doi: 10.2147/NSS.S181365

OBJECTIVE: To summarize
some of the current knowledge about the potential effects of exogenous melatonin on puberty

FINDINGS: This review suggests that the role of melatonin in sexual maturation and the timing of puberty is understudied in humans. The three human studies that have examined the question have done so as an ancillary research question in small samples of children and youth, some of whom had neurodevelopmental disorders. This limits the generalizability to the general population and is insufficient evidence to draw conclusions for patients with mental health and neurological disorders. Further experimental studies on the impact of melatonin on puberty, notably in non-seasonal mammals, and advances in the research about the intermediary processes between melatonin and kisspeptin activation, could ultimately inform us about the potential influence of exogenous melatonin on puberty.

The effects of melatonin administration on disease severity and sleep quality in children with atopic dermatitis: A randomized, double-blinded, placebo-controlled trial
https://www.ncbi.nlm.nih.gov/pubmed/30160043
doi: 10.1111/pai.12978

OBJECTIVE: To determine the effects of melatonin administration on disease severity and sleep quality in children diagnosed with atopic dermatitis (AD).

FINDINGS: Following 6 weeks of intervention, melatonin supplementation significantly improved SCORAD index, serum total IgE levels, and CSHQ scores. Though melatonin had no significant impact on pruritus scores, high sensitivity C-reactive protein, sleep-onset latency, total sleep time, weight and BMI compared with placebo. Overall, melatonin supplementation had beneficial effects on disease severity, serum total IgE levels and CSHQ among children diagnosed with AD.

2019

Exogenous melatonin as a treatment for secondary sleep disorders: A systematic review and meta-analysis
https://www.ncbi.nlm.nih.gov/pubmed/29908879
doi: 10.1016/j.yfrne.2018.06.004

OBJECTIVE: To determine the efficacy of exogenous melatonin versus placebo in managing secondary sleep disorders.

FINDINGS: Meta-analysis of the data from a series of studies with small sample size demonstrates that exogenous melatonin improves the sleep quality of secondary sleep disorders. Based on the current advantages of melatonin in the management of secondary sleep disorders, it is hoped that there will be a tremendous growth in the use of melatonin application worldwide. Besides, little evidence is available regarding the adverse effects of long-term use of melatonin. Clinicians should be alert to these shortcomings but also aware of the potential role of melatonin in clinical psychiatry and sleep medicine.

Advances of Melatonin-Based Therapies in the Treatment of Disturbed Sleep and Mood
https://www.ncbi.nlm.nih.gov/pubmed/31123831
doi: 10.1007/164_2018_139

OBJECTIVE: To review the role of melatonin in the circadian regulation of sleep and mood and the phase-shifting and sleep-promoting properties of exogenous melatonin and melatonin agonists and outline how melatonin and melatonin agonists might be used for treatment of various sleep and mood disorders.

FINDINGS: The phase-shifting and sleep-promoting effects of melatonin plus additional effects of melatonin agonists on melatonin and serotonin receptors have shown promise for novel treatments for a variety of circadian, sleep and mood disorders. Importantly, the main advantage melatonin and its agonists offer over traditional sleep and depression treatments is that they assist to restore circadian function which is often misaligned in these disorders and which is increasingly thought to be a causal mechanism and part of the aetiology of sleep and mood disorders. Treatments that fail to address the misaligned circadian system present in sleep and mood disorders may not fully address the underlying causes, and for this reason, further investigation on the potential for melatonin-based treatments should be undertaken.

Assessment of the Evidence

Endogenous melatonin provides widespread health benefits for the human body across many functional systems. Exogenous melatonin is strongly evidenced as an effective sleep aid for sleep onset (meaning, falling asleep) and less strongly for night wakings and other other sleep-related applications in adults aged 55 and older.

However, the literature is glaringly lacking in randomized, controlled trials as well as research on younger adults, teenagers, adolescents, children, and infants. Existing studies utilize small subject pools and short- to medium-term time frames for research, most stopping short at 3 months and few-to-none lasting more than one year. There is no evidence yet that consistent long-term use is safe for any age group. Dosing remains a challenge and a standard dosing table does not yet exist, although it has been long established that overdoses cause receptors in the brain to become unresponsive and supplementation to be rendered useless. Given the lack of information about dosing, it is impossible to determine what amount constitutes an overdose without investigative blood work. Melatonin supplements are almost entirely unregulated in the United States, so high doses are regularly consumed. While high doses don’t appear to have extreme deleterious effects on humans, the fatal dose is yet unknown. Future studies are needed to ameliorate concerns about safety, dosage, and pediatric use.

Promoting Better Sleep

While I cannot make any formal recommendations to you about whether or not to give your child melatonin, I can suggest some solutions to help with sleep outside of melatonin supplements.

  • Eating lots of fresh fruits, vegetables, whole grains, and low fat protein sources provides plenty of tryptophan as well as group B vitamins, minerals, and unrefined carbohydrates, all of which supports healthy sleep. Reach for things like salmon, poultry, eggs, spinach, seeds, milk, soy products, and nuts to get a good dose of sleep-promoting nutrients. (Source and Source)
  • Tart Montmorency cherries contain high levels of phytochemicals including melatonin. Cherry juice is a natural source of plant-based exogenous melatonin and may help support good sleep. (Source)
  • Exercise in the mornings can improve the quality of nighttime sleep by “increasing parasympathetic nerve activity.” However, high-intensity exercise in the evening should be avoided. Getting your child out for some fresh air every morning may make your bedtime routine a breeze. (Source)
  • Help your child avoid blue light LED sources like smartphones, tablets, and TVs near bedtime as this type of light suppresses endogenous melatonin. (Source)
  • In one of the studies referenced in this Guide, a young girl did not respond to melatonin treatments but was later diagnosed with bipolar disorder, medicated with risperidone, and subsequently experienced improved sleep. If your child is really struggling, it may be worthwhile to seek out age-appropriate therapy to rule out other treatable sources of difficulty. (Source)

The Bottom Line

Do melatonin supplements help your child? Unless you’re using pharmaceutical grade supplements under the strict care of a physician, my best answer is maybe. But it’s hard to know what your child really needs in the way of a dose without extensive blood work . The placebo effect is also in play to an extent. If you and your child believe the supplement works, it’ll probably work even better than the actual physiological impact, if there is one to begin with.

Will melatonin supplements seriously harm your child? Probably not, but there’s no guarantee and there are other effective options that don’t involve using unregulated supplements with potentially harmful impurities.


If you discover any errors in my work, please contact me at peacefulmom(at)peaceigive.com.