With many medications off the table during pregnancy, you might think to turn to a natural sleep supplement like melatonin. However, melatonin has not yet been proven to be safe during pregnancy, and therefore should only be used under the close guidance of a doctor. Here’s what you need to know about using melatonin while pregnant—and what else you can do to catch some quality sleep before the baby comes.
What Is Melatonin?
Melatonin is a hormone that our bodies produce naturally to help regulate sleep cycles. When it’s dark, our bodies make more melatonin, causing us to be sleepy. Melatonin is also sold over the counter as a sleep aid. Retail melatonin is usually made in a lab with synthetic ingredients that mimic the natural hormone. In dosages ranging from 1 mg to 10 mg or even higher, melatonin is sometimes combined with other herbal ingredients and marketed to promote restfulness or calm. Melatonin seems to be safe for most people to use on a short-term basis (and under the guidance of a doctor). In particular, melatonin may be helpful in treating jet lag, delayed sleep-wake phase disorder, some types of anxiety, and certain sleep difficulties in kids.
Is It Safe to Take Melatonin During Pregnancy?
Melatonin is not commonly prescribed during pregnancy. Quite simply, there just has not been a lot of research to show how pregnant people respond to it. “There is currently minimal safety data available regarding the use of melatonin in pregnancy,” says Danielle Jones, MD, an OB/GYN and creator of the Mama Doctor Jones blog. “Although we don’t have any data to suggest a clear evidence of harm, we also lack data to indicate that this supplement is safe.” Research published in 2022 reviewed available studies in humans, and suggested that while melatonin is “probably” safe during pregnancy and lactation, there is a lack of randomized, controlled studies examining its safety and efficacy. It also noted that none of the studies measured how well melatonin treats insomnia. There’s also the issue of quality control. As a dietary supplement, melatonin is not regulated closely by the Federal Drug Administration (FDA) the way over-the-counter medication or prescription drugs are. Researchers have found that melatonin supplements may contain a much higher or lower dose of the hormone than their labels indicate. Some even contained ingredients not listed on the label. Ingesting a higher dose of a supplement or unknown ingredients isn’t good for anyone, but especially concerning for pregnant people. Still, some doctors approve of melatonin for pregnant patients with sleep troubles, citing widespread use among the general population with minimal evidence of dangers. “Short-term use is likely relatively safe, especially after the first trimester,” says Lindsay Appel, MD, a Baltimore-area OB/GYN.
Potential Benefits of Melatonin During Pregnancy
Although studies on melatonin use in pregnancy are still scant, there are a few areas of ongoing research that have experts’ attention. For instance, animal studies suggest melatonin supplementation may help decrease the risk of intrauterine growth restriction and preeclampsia. However, these early findings are not conclusive enough to prompt any major medical organizations to recommend melatonin for pregnant people. Neither the American College of Obstetricians and Gynecologists nor the Society for Maternal-Fetal Medicine endorse melatonin use in pregnancy.
What If I Take Melatonin Before Realizing I’m Pregnant?
Given minimal evidence of harm, there is probably no reason to worry if you discover you are pregnant while taking melatonin. Still, as soon as you suspect or discover you are pregnant, it’s important to discontinue any supplements, medications, or substances until you clear their use with a healthcare provider. Based on your individual medical history and the health status of your pregnancy, they can guide you as to whether it’s a good idea to discontinue melatonin or continue to take it with specific precautions in mind.
Pregnancy-Safe Alternatives to Melatonin
Even without melatonin, you don’t have to suffer through sleepless nights for nine months. If you’re having more than the average amount of difficulty sleeping during pregnancy and it’s affecting your overall health, talk to your doctor or midwife about taking a safe sleep aid. Some sleeping medications commonly prescribed during pregnancy include:
Diphenhydramine (Benadryl): “Most obstetricians recommend this as a first-line option, since we know more about the safety profile on this medication in regards to pregnancy,” says Dr. Jones.Doxylamine (Unisom): Dr. Appel notes that pregnant people can safely use this medication at the full dose recommended for adults.
There are also several non-pharmaceutical ways to manage sleeplessness and insomnia in pregnancy, most of which involve maintaining good sleep hygiene. Dr. Appel recommends:
Avoiding watching TV or using your phone in bed Practicing meditation or breathing exercises prior to bedtime Using a pregnancy pillow to increase comfort and support in bed Sticking to a regular bedtime
Safety Precautions
With little research to back up its safety or usefulness for pregnant people specifically, melatonin should generally be avoided when you are expecting. However, if you are having persistent sleep troubles and want to try melatonin, follow these precautions:
Discuss dosage and duration with your doctor: “In general, the lowest dose should be used over the lowest period of time to limit exposure to the growing pregnancy," says Dr. Appel. Purchase a product with a USP (United States Pharmacopeia) label: This indicates the maker has opted to have its melatonin product tested for quality. Monitor side effects: Keep in regular touch with your doctor about how you are responding to melatonin.
A Word From Verywell
If you use or are thinking about using melatonin as a sleep aid during pregnancy, it’s important to speak to a healthcare provider and get their advice before doing so. In some cases, they may suggest a safer alternative, or help you identify the reasons you’re having trouble sleeping in the first place. Between physical discomfort and increased stress, sleeping well during pregnancy isn’t always easy, but your team of medical professionals can provide you with more information about treatment options and suggest lifestyle changes so you can get much-needed rest before the baby arrives.