Melatonin use while Breastfeeding
Drugs containing Melatonin: Melatonin Time Release, Bio-Melatonin, VesPro Melatonin, SGard, Health Aid Melatonin
Melatonin Levels and Effects while Breastfeeding
Summary of Use during Lactation
Melatonin is the hormone produced by the pineal gland that plays a role in regulating sleep and circadian rhythm as well as a possible role in gut-brain signaling. It is a normal component of breastmilk, with concentrations higher during nighttime than daytime. Some authors suggest that mothers should nurse in the dark at night in order to avoid reductions in the melatonin content of breastmilk, which could disturb infant sleep patterns. Differentiating milk pumped during the day from milk pumped during darkness has also been suggested for women pumping milk for their infants. Some studies have attributed longer sleep time in breastfed infant than in formula-fed infants to melatonin in breastmilk. Another study found higher colostrum melatonin levels at night which appeared to increase the phagocytic activity of colostral cells against bacteria. Exogenous administration of melatonin has no specific use during breastfeeding and no data exist on the safety of maternal use of melatonin during breastfeeding. However, doses higher than those expected in breastmilk after maternal supplementation have been used safely in infants. It is unlikely that short-term use of usual doses of melatonin in the evening by a nursing mother would adversely affect her breastfed infant, although some authors recommend against its use in breastfeeding because of the lack of data and a relatively long half-life in preterm neonates.
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Melatonin is a normal component of human milk which is synthesized from the amino acid tryptophan.
Maternal Levels. Ten nursing mothers who were 3 to 5 days postpartum had serum and breastmilk melatonin levels measured between 2 pm and 5 pm and again between 2 am and 4 am. The breastmilk melatonin level averaged 23 ng/L at night, an average of 35% of the maternal serum concentration. Melatonin was undetectable (<10 ng/L) in milk during the daytime. Six of the mothers collected milk after each feeding for 24 hours once within 3 months of delivery. All mothers exhibited a marked circadian rhythm of melatonin excretion into breastmilk with detectable levels first occurring in the evening and dropping to undetectable levels in the morning.
Twenty-one mothers collected breastmilk samples 5 times in a 24-hour period between day 5 and 10 postpartum. The median melatonin concentration in daytime milk (10 an to 10 pm) was 1.5 mg/L and the median concentration in nighttime milk (10 pm to 10 am) was 7.3 ng/L. No statistically significant difference was found between the breastmilk of mothers with preterm and fullterm infants.
Twenty-four healthy mothers and 24 mothers with allergic eczema were studied in a crossover fashion to watch either a humorous video, a nonhumorous video, or no video at 2-week intervals. Melatonin was measured in breastmilk 5 times between 10 pm and 6 am. Melatonin levels were higher at all times in the mothers who had watched the humorous video. The melatonin levels in mothers with eczema were generally lower than in normal mothers, but had a greater increase to similar levels in both groups after viewing the humorous video. The highest milk melatonin levels occurred at the 2 am sampling in all phases of the study, with a peak of 20.8 ng/L in healthy mothers and 19.9 ng/L in those with eczema.
In studies in which exogenous oral melatonin was given to women, the resulting serum melatonin was variable, but peak serum concentrations ranged from 1.1 to 2.6 mcg/L for each 1 mg administered. This would result in an average increase in breastmilk melatonin concentration from 0.4 to 1 mcg/L for each 1 mg administered to the mother, based on an average milk concentration of 35% of the maternal serum concentration. While the resulting concentrations would be higher than the typical physiologic peak milk concentrations of 0.02 mcg/L, it would present a considerably lower dose to the infant than the 10 mg/kg dosages of melatonin that have been safely administered to neonates in clinical studies.
One study found that breastmilk melatonin concentration was inversely correlated with breastmilk prolactin concentration and was higher in women experiencing fatigue in the morning.
Five nursing mothers provided breastmilk samples every 2 hours over a 24-hour period. Melatonin was undetectable during the day, but began to rise at about 8 pm, reaching a peak at about 3 am, and then declining.
Thirty women who were 48 to 72 hours postpartum provided 2 colostrum samples, one at noon and one at midnight. Melatonin levels in colostrum averaged about 16 ng/L at noon and 36 ng/L at midnight.
A study in Turkey found that melatonin colostrum levels measured between 1:00 and 3:00 am between 48 and 72 hours postpartum were higher in mothers who delivered vaginally (mean 266 ng/L) than in those delivering by elective cesarean section (mean 205 ng/L) or emergency cesarean section (mean 167 ng/L). All differences between groups were statistically significant.
Infant Levels. A study of 8 breastfed and 6 formula-fed infants found different patterns of the melatonin metabolite, 6-sulfatoxymelatonin, in their urine. Breastfed infants had a sinusoidal excretion pattern with a peak at 6 am and a trough at 6 pm. Formula-fed infants had a simple increase in the metabolite that was at baseline between about 8 pm and 4 am with a peak at about noon.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
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2. Katzer D, Pauli L, Mueller A et al. Melatonin concentrations and antioxidative capacity of human breast milk according to gestational age and the time of day. J Hum Lact. 2016;32:NP105-NP110. PMID: 27121237
3. Sanchez-Barcelo EJ, Mediavilla MD, Reiter RJ. Clinical uses of melatonin in pediatrics. Int J Pediatr. 2011;2011:892624. PMID: 21760817
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6. Rudzik AE, Robinson L, Ball HL. Infant sleep duration and melatonin levels in exclusively breastfed and exclusively formula fed infants. Am J Hum Biol. 2016;28:294. Abstract P43. DOI: doi:10.1002/ajhb.22831
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11. Kimata H. Laughter elevates the levels of breast-milk melatonin. J Psychosom Res. 2007;62:699-702. PMID: 17540228
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