Many pregnant women suffer from insomnia and sleep issues. This leads them to wonder if taking melatonin supplements is safe during pregnancy.
Melatonin is a popular over-the-counter sleep aid. It’s a natural hormone produced by the body to regulate sleep-wake cycles. Melatonin supplementation may help pregnant women fall asleep faster, sleep better, and be more well-rested.
But is melatonin safe to use when you’re expecting? Can it impact mom’s health or baby’s development?
This comprehensive guide examines if and when pregnant women can take melatonin supplements. It provides research-backed information on the safety, effectiveness, benefits, and risks of using melatonin in pregnancy.
Key Takeaways on Melatonin Use During Pregnancy:
- Melatonin is likely low risk during pregnancy, but more research is still needed on long-term use.
- Small doses of melatonin up to 5mg/day appear safe, but high doses may cause issues.
- Melatonin should be avoided in the 1st trimester due to lack of safety data.
- Potential benefits like improved sleep quality must be weighed against unknown fetal effects.
- Discuss melatonin use with your doctor and use the lowest effective dose.
- Melatonin may be safer than prescription sleep meds during pregnancy.
- Non-drug sleep hygiene techniques should be tried first before melatonin.
Is Melatonin Considered Safe During Pregnancy?
The safety profile of melatonin during pregnancy is not yet conclusive. But based on current research, melatonin supplementation in doses of 3-5mg appears to be relatively low risk during pregnancy.
Melatonin is unlikely to increase the chance of miscarriage or major birth defects according to preliminary studies. But data on long-term use over 9 months of pregnancy is limited.
The American College of Obstetricians and Gynecologists (ACOG) states that occasional short-term use of melatonin is likely safe during pregnancy. But ACOG recommends avoiding extended use until more safety studies are done.
Most experts agree pregnant women should use the lowest effective dose of melatonin for the shortest time period possible. Doses of 2-5mg for 4 weeks or less is thought to be reasonably safe.
Always discuss melatonin use with your prenatal provider first. More research is still needed on fetal development effects with long-term maternal use.
Melatonin Levels During Pregnancy
Melatonin is a hormone produced naturally by the pineal gland in the brain. It helps coordinate sleep-wake cycles and other daily circadian rhythms.
During pregnancy, a woman’s melatonin levels fluctuate significantly compared to non-pregnant women. The placenta also secretes melatonin that passes to the developing baby.
Plasma melatonin concentrations are highest during the third trimester. They elevate in early pregnancy then decline in mid-pregnancy before rising again as delivery approaches. This may contribute to increased sleep difficulties during the first and third trimesters.
Term newborns have very low levels of circulating melatonin at birth. Premature infants have even lower concentrations. After birth, babies start producing their own melatonin around 3-6 months old.
Because of these variations, some experts recommend against melatonin supplementation in pregnancy until the third trimester when endogenous levels are highest naturally.
Why Pregnant Women Use Melatonin Supplements
Up to 90% of expectant mothers deal with some degree of insomnia and sleep problems during pregnancy. This can occur during any trimester but is most common in the 1st and 3rd trimesters.
Contributing factors include hormonal changes, nausea, back pain, fetal movement, frequent urination, stress, and anxiety. Sleep troubles can negatively impact both maternal and infant health.
This leads many pregnant women to turn to melatonin supplements in hopes of getting better sleep. Reasons women take melatonin during pregnancy include:
- Fall asleep faster and sleep through the night
- Improve sleep quality and duration
- Regulate disrupted circadian rhythms
- Reduce insomnia from hormonal changes
- Alleviate nausea and morning sickness
- Treat antepartum depression and anxiety
- Avoid risks of prescription sleep meds
However, melatonin will not treat all underlying causes of insomnia during pregnancy. Proper sleep hygiene and other non-drug measures should be tried first before considering melatonin supplementation.
Is Melatonin Effective for Pregnancy Insomnia?
Some research indicates that melatonin can help pregnant women fall asleep faster and stay asleep longer. Studies have found short-term melatonin use may improve overall sleep quality in pregnancy.
A 2019 randomized controlled trial gave 80 pregnant women either 5mg melatonin or placebo 30 minutes before bedtime for 4 weeks. The women taking melatonin fell asleep significantly faster and slept better overall compared to the control group.
Another study in 60 pregnant women with insomnia found 3mg melatonin before bedtime for 2 weeks increased sleep duration by nearly 1 hour versus placebo.
However, other studies have shown little benefit from melatonin in pregnancy. A 2018 review looked at 4 trials and concluded melatonin did not have clinically meaningful effects on insomnia symptoms or sleep quality in pregnant women.
Much more research is still needed on melatonin’s efficacy and safety during pregnancy. But short-term use shows promise for relieving insomnia woes in some expectant mothers.
Dangers of High Melatonin Doses in Pregnancy
While low doses up to 5mg appear reasonably safe, high melatonin doses may be dangerous during pregnancy.
Studies using extremely high doses of 100-200mg/day found potential risks, including low birth weight, preeclampsia, and altered fetal development. However, such massive doses are atypical.
The typical supplemental dosage for adults ranges from 1-10mg daily, often before bedtime. Doses above 10mg have not been well studied for long-term use during pregnancy and are not recommended.
High melatonin doses could also potentially impact contractions during labor. However, more research is required to determine if high doses really increase pregnancy complications.
To be cautious, it’s advisable for pregnant women to avoid sustained use of melatonin above 5mg daily until more data on fetal safety is available. Always consult your doctor on appropriate dosing.
Possible Benefits of Melatonin During Pregnancy
In addition to better sleep, melatonin use in pregnancy may offer other benefits for mom and baby. Potential advantages may include:
- Reduced nausea and vomiting
- Decreased risk of preeclampsia
- Lower oxidative stress and inflammation
- Improved mood and pregnancy depression
- Protection against preterm birth
- Higher infant birthweight
- Better development of the fetus
- Enhanced immune function
- Increased progesterone levels
These benefits correlate with melatonin’s roles in the human body, including as an antioxidant. But most proposed therapeutic uses beyond sleep remain unproven and require more controlled research.
Is Melatonin Recommended in 1st Trimester?
Most experts advise against using melatonin supplements during the first trimester of pregnancy until more safety data is available.
The rates of miscarriage and defects are highest in the first trimester when the fetus is rapidly developing. Since melatonin easily crosses the placenta, unknown impacts on fetal development are possible.
One 2021 study did find a slightly increased risk of first trimester miscarriage in women taking 3-5mg melatonin nightly versus non-users. However, the miscarriage rate was still within the normal range.
Melatonin use in the first 12 weeks is thought to pose some potential risks. But large well-controlled studies are limited. It’s unclear if low dose melatonin really does increase the chances of first trimester pregnancy loss.
Many providers recommend avoiding melatonin at least until the 2nd trimester if possible when organogenesis is complete. But some may permit occasional use in the 1st trimester if sleep issues are severe.
Melatonin vs. Prescription Sleep Aids in Pregnancy
For pregnant insomniacs, melatonin may offer advantages over prescription sleep medications like Ambien or Lunesta.
Most prescription sedatives cross the placenta at higher concentrations with more potential fetal side effects. Many lack safety data for pregnancy use.
In contrast, melatonin has not been shown to significantly impact babies exposed in utero at low supplemental doses. Plus, it’s thought to be less habit-forming than many prescription sleep drugs.
If pregnant women require sleep medications, short-term melatonin is likely a safer first choice. But non-pharmacological sleep hygiene techniques should still be tried before any drugs or supplements.
Of course, you should always consult your obstetrician before taking any sleep aid, including melatonin supplements. Never exceed recommended dosing.
Potential Risks and Side Effects of Melatonin in Pregnancy
While low doses of melatonin up to 5mg/day appear relatively low risk, potential adverse effects are still possible. Reported side effects may include:
- Increased risk of miscarriage or birth defects
- Premature birth
- Fetal developmental issues
- Low birth weight
- Gestational diabetes
- Excessive contractions or labor induction
- Postpartum depression
- Headaches, dizziness, nausea
- Hormone level changes
However, these side effects seem relatively uncommon at typical melatonin doses. And risks likely increase substantially with excessive long-term dosing.
Melatonin could also potentially interact with other supplements, herbs, or medications taken during pregnancy. Be sure to disclose all drugs to your doctor.
Of course, many expectant mothers safely take melatonin without issues. But due to limited safety data, melatonin use in pregnancy should be approached cautiously.
Tips for Taking Melatonin During Pregnancy
If you plan to take melatonin supplements while pregnant, consider these tips to minimize risks:
- Check with your doctor first and use the lowest effective dose.
- Start with 1-3mg and only increase if needed, up to 5mg maximum.
- Take for the shortest time period possible, ideally only as needed.
- Avoid prolonged daily use and extended high doses.
- Use for 4 weeks or less at a time; cycle off periodically.
- Time doses to 6-8 hours before desired wake time.
- Avoid melatonin in 1st trimester if possible; wait until 2nd or 3rd.
- Look for high-quality pharmaceutical grade melatonin.
- Discontinue use if any concerning side effects develop.
- Consider stopping at least 2 weeks before expected due date.
- Make sure to practice good sleep hygiene habits along with melatonin.
Again, consult your doctor about the advisability of using melatonin while you’re expecting. Be prudent and conservative with dosing.
Natural Alternatives to Melatonin During Pregnancy
Some moms-to-be wish to avoid melatonin and sleep medications entirely during pregnancy. In that case, consider these tips to encourage healthy sleep naturally:
- Establish a relaxing pre-bed routine each night.
- Limit daytime naps to 30 minutes.
- Avoid screens and digital devices before bed.
- Create an optimal sleep environment that is cool, dark and quiet.
- Go to bed and wake up at the same time daily.
- Get exposure to bright natural light, especially early in the day.
- Practice meditation, deep breathing, or progressive muscle relaxation.
- Consider safe herbal teas like chamomile or valerian root.
- Use pregnancy pillows and mattresses for comfort and support.
- Exercise regularly earlier in the day.
- Maintain healthy nutrition and avoid heavy meals before bed.
- Talk to your doctor if anxiety or depression disrupt sleep.
Making positive lifestyle changes can often significantly improve sleep troubles without the need for medications like melatonin. But check with your provider before taking any new herbs or supplements.
The Bottom Line – Is Melatonin Safe During Pregnancy?
Small doses of melatonin up to 5mg daily appear reasonably safe for most pregnant women struggling with insomnia and sleep issues. But data on long-term fetal effects is still lacking.
Melatonin use is likely fine for short periods during the 2nd and 3rd trimesters. But many experts recommend avoiding it in the 1st trimester until more safety research is conducted.
For pregnant women, melatonin should be used conservatively and the lowest effective dose taken for the shortest time period possible. Maximum doses above 5mg are not advised.
Non-drug sleep hygiene measures should be tried first before considering melatonin or other supplements. Discuss use with your obstetrician and properly weigh the pros and cons for your individual situation.
While melatonin is likely a relatively low-risk option, more large controlled studies on long-term use throughout pregnancy are still needed. But so far, melatonin appears reasonably safe for cautious short-term use in expectant mothers suffering from severe sleep problems.
The Takeaway – Can I Take Melatonin While Pregnant?
Melatonin can help pregnant women sleep better, but should be used conservatively. Small doses up to 5mg at bedtime are likely safe for short periods during the 2nd and 3rd trimesters. But check with your doctor first. Try sleep hygiene techniques before considering melatonin. More research is still needed on long-term fetal effects. Use the lowest effective melatonin dose for the shortest time frame possible. Avoid in 1st trimester and extended high doses. Be prudent and weigh pros vs potential risks.