Difficulty sleeping is common during pregnancy. Hormonal changes, physical discomfort, stress, frequent urination, heartburn, and changes in breathing can all make it harder to fall asleep or remain asleep.
Because melatonin is widely available without a prescription in the United States, it may seem like a simple or natural solution. But natural does not automatically mean proven safe during pregnancy.
Melatonin supplements have not been studied well enough in pregnant people to establish their overall safety. Current human research has not suggested a clear increase in birth defects, but the available evidence remains limited.
Medical notice: This article provides general educational information. It does not replace individualized advice from your doctor, midwife, pharmacist, or another qualified healthcare professional. Speak with your prenatal care provider before starting, stopping, or changing a medicine or supplement during pregnancy.
What Is Melatonin?
Melatonin is a hormone naturally made by the body. It helps regulate the circadian rhythm, which influences when you feel awake and when you feel ready to sleep.
The body generally produces more melatonin during periods of darkness. Melatonin levels also naturally change during pregnancy and appear to be highest during the third trimester before returning toward previous levels after delivery.
Manufactured melatonin is sold as a supplement in forms such as:
- Tablets
- Capsules
- Gummies
- Liquids
- Extended-release products
- Combination sleep products
The melatonin naturally produced by your body is not the same as taking a concentrated supplement. Supplements can expose the body to amounts that differ from normal hormone production.
Can You Take Melatonin While Pregnant?
Melatonin is not generally recommended for routine use during pregnancy without guidance from a healthcare professional.
The reason is not that melatonin has been proven to cause harm. Instead, there is not enough pregnancy-specific research to confidently determine its safety, appropriate use, or possible effects on pregnancy and childhood development.
MotherToBaby reports that taking melatonin supplements during pregnancy has not been well studied. It also notes that many supplements are not routinely recommended during pregnancy unless a healthcare provider has advised their use for a medical reason.
The United Kingdom’s National Health Service similarly states that melatonin is not usually recommended during pregnancy because little is known about its effects on babies. It advises anyone who becomes pregnant while taking melatonin to discuss whether to continue or stop it with a doctor.
The safest conclusion is therefore:
Do not begin taking melatonin during pregnancy without first discussing it with your prenatal healthcare provider.
Does Melatonin Increase the Risk of Birth Defects?
It is not currently known whether melatonin supplements increase the chance of birth defects.
The few human studies that have examined melatonin exposure have not suggested an increased chance of birth defects. However, the number and quality of available studies are not enough to prove that there is no risk.
Research is also limited because some studies have involved melatonin being used as part of treatment for particular medical conditions rather than as a common over-the-counter sleep supplement.
Results from those specialized studies cannot automatically be applied to every pregnant person taking melatonin for occasional insomnia.
Does Melatonin Increase the Risk of Miscarriage?
Research involving melatonin use during infertility treatment has not shown an increased chance of miscarriage.
However, these findings do not fully answer whether over-the-counter melatonin taken independently for sleep affects miscarriage risk. The available evidence remains limited.
Anyone who has taken melatonin before realizing they were pregnant should not assume that harm has occurred. Record the product name, ingredients, amount used, and timing, and discuss the exposure with a doctor or pharmacist.
Can Melatonin Affect Other Pregnancy Outcomes?
Studies have not adequately determined whether melatonin supplements affect:
- Birth weight
- Preterm delivery
- Fetal growth
- Pregnancy complications
- Childhood behavior
- Learning or development
MotherToBaby reports that studies have not been completed to determine whether melatonin affects low birth weight or future behavior and learning.
The absence of evidence showing harm is not the same as proof that the supplement is safe.
Is a Low Dose of Melatonin Safe During Pregnancy?
There is no universally established over-the-counter melatonin dose that has been proven safe for all pregnant people.
Appropriate decisions may depend on:
- Your stage of pregnancy
- How long the sleep problem has lasted
- Why you are having trouble sleeping
- Other medicines and supplements you use
- Your health history
- The exact melatonin product
- Whether the product contains additional ingredients
Do not assume that a product is safe merely because its front label describes it as low dose, natural, drug-free, or pregnancy-friendly.
The amount shown on a supplement label may also not always match the amount in the product. NCCIH cites research in which many tested melatonin gummy products contained amounts that differed substantially from their labels.
Are Melatonin Gummies Safer Than Tablets?
No evidence shows that a gummy is safer during pregnancy simply because it is easier to take or tastes like candy.
Gummies may contain:
- Added sugar
- Flavorings
- Other vitamins or herbs
- Multiple sleep-related ingredients
- Amounts of melatonin that do not precisely match the label
NCCIH reports that 22 of 25 tested over-the-counter melatonin gummy products were inaccurately labeled. Some contained substantially more melatonin than the label indicated.
Always show your healthcare provider the complete ingredient list rather than mentioning only the product’s brand name.
What If You Already Take Melatonin?
Do not panic, and do not make a major treatment decision based solely on an online article.
Contact your doctor, midwife, or pharmacist and provide:
- The full product name
- A photograph of the ingredient label
- The amount you took
- How frequently you used it
- The dates or pregnancy weeks when you used it
- Other medicines and supplements you take
The NHS advises people who become pregnant while taking melatonin to speak with their doctor, who can help determine whether it should be continued or stopped.
Does Melatonin Actually Treat Insomnia?
Melatonin may help some people fall asleep slightly sooner, but it does not necessarily improve every aspect of insomnia.
NCCIH reports that research has found possible improvement in sleep-onset latency—the time needed to fall asleep—but not consistent improvement in overall sleep quality or time spent awake during the night. Clinical practice guidelines cited by NCCIH have recommended against using melatonin for chronic insomnia because the evidence is insufficient.
Persistent sleep problems may have another cause that melatonin will not address, including:
- Sleep apnea
- Restless legs syndrome
- Anxiety or depression
- Pain
- Heartburn
- Medication side effects
- Breathing changes
- An irregular sleep schedule
Treating the underlying cause may be more useful than taking a supplement without an evaluation.
Why Is Sleep Difficult During Pregnancy?
Sleep problems are common during pregnancy and do not necessarily mean something is seriously wrong.
ACOG explains that changes in estrogen and progesterone can affect sleep patterns during pregnancy. Weight gain and airway swelling may also contribute to snoring and obstructive sleep apnea, particularly later in pregnancy.
Other common sleep disruptions can include:
- Needing to urinate frequently
- Nausea or heartburn
- Back, hip, or pelvic discomfort
- Fetal movement
- Stress about pregnancy or delivery
- Difficulty finding a comfortable position
- Changes in daily routine
Understanding the cause can help your healthcare provider recommend an appropriate approach.
Sleep Habits to Try Before Using a Supplement
General sleep habits may help with mild or occasional difficulty sleeping.
Keep a regular schedule
Try to go to bed and wake up at approximately the same time each day. A highly inconsistent schedule can disrupt the body’s natural sleep-wake rhythm.
Create a comfortable bedroom
Keep the room quiet, dark, and comfortably cool. Reduce unnecessary noise and light where practical.
Reduce bright screens before bed
Phones, tablets, televisions, and computers expose you to bright light and stimulating content. Consider setting aside quiet time before bedtime.
Watch the timing of caffeine
Caffeine can continue affecting the body for several hours. Discuss an appropriate pregnancy caffeine limit with your prenatal care provider and avoid consuming it close to bedtime.
Avoid heavy meals immediately before bed
A large meal near bedtime can worsen discomfort or heartburn for some people. Your prenatal care provider can help when reflux repeatedly interferes with sleep.
Use relaxation techniques
Gentle breathing, quiet music, a warm bath, or another calming bedtime routine may help the body prepare for sleep.
ACOG and the National Heart, Lung, and Blood Institute recommend practices such as maintaining a regular schedule, limiting stimulants near bedtime, reducing bright light, and keeping the bedroom comfortable.
Do not replace melatonin with another herb, supplement, sleep gummy, or “natural remedy” without checking it with a healthcare professional. Other natural products may also lack pregnancy safety research.
When Should You Discuss Sleep Problems With Your Doctor?
Talk with your prenatal healthcare provider when:
- Sleep difficulty continues for several weeks
- Poor sleep is interfering with work or everyday activities
- You regularly feel extremely sleepy during the day
- You snore loudly or wake up gasping
- Someone notices pauses in your breathing
- You experience uncomfortable sensations in your legs at night
- Pain, heartburn, or breathing problems repeatedly wake you
- Anxiety, sadness, or racing thoughts make sleep difficult
- You believe a medicine is interfering with sleep
- You feel unable to function safely because of exhaustion
ACOG advises discussing sleep problems with an obstetrician or another healthcare professional because symptoms may require screening for insomnia, sleep apnea, restless legs syndrome, anxiety, depression, or another condition.
Frequently Asked Questions
Is melatonin natural?
Melatonin is a hormone naturally produced by the body. Products sold in bottles are manufactured supplements that provide an additional amount. A substance being naturally present in the body does not prove that taking extra amounts is safe during pregnancy.
Is melatonin safer than a prescription sleeping medicine?
Not necessarily. Over-the-counter availability does not mean a product is better studied or safer during pregnancy.
A healthcare professional should compare the possible benefits and risks of all available options based on your individual situation.
Can I take melatonin during the first trimester?
There is not enough evidence to identify a universally safe stage of pregnancy for routine melatonin supplementation. Consult your doctor, midwife, or pharmacist before using it during any trimester.
What should I do if I took melatonin once?
A single exposure does not automatically mean a pregnancy has been harmed. Note the exact product and amount, then discuss it with your healthcare provider or pharmacist.
Can I take herbal sleep products instead?
Do not assume that herbal sleep products are safer. Many herbs and combination supplements have limited pregnancy research and may interact with medicines.
Can I take melatonin while breastfeeding?
Melatonin made naturally by the body is present in breast milk, particularly at night. Supplemental melatonin during breastfeeding has not been well studied. MotherToBaby recommends discussing supplements with a healthcare provider while breastfeeding.
The Bottom Line
Melatonin supplements have not been studied well enough during pregnancy to be considered routinely safe for everyone.
The limited human evidence has not suggested an increased chance of birth defects, but research has not answered important questions about other pregnancy outcomes or childhood development.
Before taking melatonin:
- Discuss the sleep problem with your prenatal healthcare provider.
- Show them the exact product and ingredient label.
- Review other medicines and supplements you use.
- Consider whether another condition may be affecting your sleep.
- Do not substitute another supplement without professional guidance.
Persistent insomnia deserves attention. The goal should be to identify its cause and choose an approach that is appropriate for both you and your pregnancy.
Sources
- MotherToBaby: Melatonin During Pregnancy and Breastfeeding
- National Center for Complementary and Integrative Health: Sleep Disorders and Complementary Approaches
- American College of Obstetricians and Gynecologists: Sleep Health and Disorders
- NHS: Pregnancy, Breastfeeding and Fertility While Taking Melatonin
- National Heart, Lung, and Blood Institute: Healthy Sleep Habits
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