Is melatonin safe while breastfeeding?

Parents are no strangers to insomnia. We may be totally exhausted, but when our heads finally hit the pillow, our minds tend to fill with thoughts and worries, making it impossible to drift off. In situations like this, you might consider taking a supplement like melatonin, an over-the-counter sleep aid known to help with insomnia. If you’re breastfeeding, though, is melatonin safe?

Unfortunately, while some melatonin usage may be considered safe while breastfeeding, doctors don’t typically recommend it because there are still so many unknowns about safe amounts and side effects. Here’s what experts say breastfeeding parents should know about using melatonin while breastfeeding so you can make the right decision for you and your baby.  

Can you take melatonin while breastfeeding?

“Although occasional use can be considered to be safe, it is not recommended that breastfeeding women take melatonin on a regular basis,” explains Dr. Mitchell S. Kramer, chairman of the department of obstetrics and gynecology at Huntington Hospital. Why? Because, currently, there is not a lot of research or data on melatonin use while breastfeeding, he adds.

“My best advice is to first try non-medicated efforts and then to talk to your doctor and/or lactation consultant.”

— Emily Silver, nurse practitioner and lactation consultant

Emily Silver, certified family nurse practitioner, lactation consultant and co-founder of Nurture by NAPS, agrees that the data is limited when it comes to the question of whether melatonin is safe while breastfeeding. Still, her assumption is that it is likely compatible with breastfeeding, given the fact that melatonin naturally circulates in breast milk. Given the unknowns, though, Silver believes that melatonin use must be discussed with your doctor. “My best advice is to first try non-medicated efforts and then to talk to your doctor and/or lactation consultant,” she advises. 

Dr. Jessica Madden, board-certified pediatrician and neonatologist, international board-certified lactation consultant and medical director at Aeroflow Breastpumps, agrees that there is not enough research as of now to readily recommend melatonin to breastfeeding parents. Her advice is to use it sparingly, if at all.

“We unfortunately do not have any research to guide safe dosing of melatonin supplements for breastfeeding mothers,” Madden says. “Because of this, I only recommend using small doses (less than 5 mg once daily at bedtime) and for short periods of time (less than two weeks).”

Do babies get melatonin from breast milk?

Yes, breastfed babies get melatonin naturally from breast milk, according to Lactmed, a database run by the National Center for Biotechnology Information (NCBI). That’s because melatonin is a hormone our bodies produce naturally in order to regulate sleep cycles and circadian rhythms. We produce more of it at night, so that we are good and ready for sleep. For this reason, nighttime is also when melatonin tends to peak in breastmilk, usually around 3 a.m.

Melatonin in breast milk may be beneficial for little ones, Madden says. “It is postulated that the higher levels of melatonin in breast milk produced during nighttime hours help to promote infant sleep at night.”

“I am not aware of any research evaluating long-term use of melatonin while breastfeeding… Long-term effects on the baby with respect to development are not known.”

—Dr. Kecia Gaither, OB/GYN and maternal fetal medicine expert

Can taking melatonin while breastfeeding hurt my baby? 

So, what happens when a breastfeeding parent supplements with over-the-counter melatonin? Can that additional melatonin pass onto the baby? Melatonin supplements can pass into breast milk and affect babies, Kramer confirms. However, we still lack the data to know if, and at what dosage, supplemental melatonin may be too much for babies to handle or could harm them in some way.

Limited studies found no safety issues in babies when breastfeeding moms took melatonin supplements, according to Lactmed. Still, Lactmed concludes that while the short-term use of melatonin during breastfeeding isn’t likely to be harmful to babies, there is not enough data to prove this definitively.

And it’s not just the short-term usage of melatonin that concerns doctors. “I am not aware of any research evaluating long-term use of melatonin while breastfeeding,” says Dr. Kecia Gaither, double board-certified in OB/GYN and maternal fetal medicine expert. As such, she does not feel comfortable recommending its use during breastfeeding.

Kramer says that taking melatonin supplements may simply make your baby more sleepy on a short-term basis. But like Gaither, he is more concerned about the longer term effects that taking it might have on babies. “Long-term effects on the baby with respect to development are not known,” Kramer says. 

Thankfully, there are studies being done right now to access these types of questions, he says. The problem is that these studies are in the very early stages, and there is no data regarding these questions yet.

What sleep aids are safe while breastfeeding?

Since doctors don’t typically recommend melatonin use while breastfeeding, you might be wondering if there are other sleep aids that are more well studied and considered safe for nursing parents.

“Safe sleep aids that we know more about their safety profile are doxylamine and diphenhydramine,” says Kramer. Both of these are antihistamines that are often used to induce sleep and are considered safe for breastfeeding in small doses. However, Madden warns that both of these medications may impact your milk supply.

“If a breastfeeding mother opts to take either of these antihistamines, it should only be very occasionally, once their breast milk supply is fully established and ideally after the last breastfeeding or pumping session of the night,” Madden suggests. If you are considering using either of these medications as a sleep aid while breastfeeding, you should consult your doctor first.

Can I take sleeping pills while breastfeeding?

Kramer says that sleeping pills like zolpidem are considered safe while breastfeeding but should only be used occasionally, sparingly and under a doctor’s supervision. The same goes for benzodiazepines (anxiety medications sometimes used to fall asleep), he says.

The reason why zolpidem and benzodiazepines may be safe is because only small amounts of them pass into breast milk, according to research. Still, all babies are different and it may not be advisable to take these medications if you are breastfeeding a medically vulnerable baby.

“It’s always best to discuss with one’s doctor regarding their use,” Kramer advises.

What are natural alternatives to taking melatonin for sleep?

One concern with taking a sleep aid is the effect that it may have on the parent who is in charge of caring for their baby, Silver says. “I wouldn’t want a breastfeeding mom to become too sleepy to care safely for her baby overnight,” she says.

That said, both Silver and Gaither recommend trying other methods before turning to sleep aid medications and supplements. These may include: 

• Breathing exercises. 
• Mindful meditation before bed. 
• Reading a book to wind down rather than scrolling through your phone.
• Making sure to exercise each day.
• Ending the day with a warm bath or a warm cup of milk.

It’s critical for every parent to get enough sleep, so if these tricks don’t work, talk to your doctor. “Momsomnia” is a real thing, Silver says, and we each need to find a solution to it that works for us and our babies. 

Yes, being tired is part of being a parent, but we should at least be able to get some rest during those precious nighttime hours.