Melatonin in infants—physiology, pathophysiology and intervention options

Abstract

AbstractThe effectiveness of melatonin in nonorganic sleep disorders in children and adolescents has been examined in 33 randomised controlled studies [1]. This review presents the current state of knowledge on the physiology, pharmacokinetics, pathophysiology and toxicity of melatonin in infancy based on well-documented studies. Up to the third month of life, premature and full-term babies cannot produce their own melatonin, so they are dependent on exogenous supply via their own mother’s breast milk, non-pooled breast milk or non-pooled formula. Non-pooled means that a distinction should be made between melatonin-rich night milk and melatonin-poor day milk. A number of intervention studies indicate that administration of melatonin to infants may have analgesic and antioxidant effects related to ophthalmological examinations, prevention of bronchopulmonary dysplasia, and the treatment of hypoxic ischaemic encephalopathies. Since melatonin concentrations in the mother’s blood, in breast milk and, e.g., also in cow’s milk show regular day–night fluctuations, and since breastfed infants have a more stable melatonin supply and fewer sleep disorders, infants who cannot be breastfed by their own mother should preferably have chrononutrition made from non-pooled human or cow’s milk. There has recently been evidence that infantile colic is a disorder with delayed development of chronobiological rhythms.