In pregnancy, is melatonin routinely recommended for sleep?

• A. Melatonin is routinely recommended.
• B. Melatonin is not routinely recommended.
• C. Melatonin is contraindicated.
• D. Melatonin is preferred over sleep hygiene.

Answer: (B)

In pregnancy, the safety of melatonin for the developing fetus is not well established, so it’s not something you would use routinely. Melatonin crosses the placenta, and while small studies haven’t shown clear harm, there isn’t enough solid evidence to support it as a standard sleep aid for most pregnant people. Because of this uncertainty, the preferred approach is to focus on nonpharmacologic sleep strategies first—consistent sleep schedules, good sleep environment, regular exercise within limits, and addressing contributing factors like discomfort or anxiety. If sleep problems persist, a clinician might consider melatonin only in carefully selected cases and with medical supervision, rather than recommending it as a standard practice.