Summary of Use during Lactation

Stevia (Stevia rebaudiana) leaves contain rebaudiosides and steviosides. The stevia leaf has been studied for treating diabetes and hypertension, although results are equivocal. Stevia has no specific lactation-related uses. No data exist on the excretion of any components of stevia into breastmilk or on the safety and efficacy of stevia in nursing mothers or infants. Rebaudioside A is "generally recognized as safe" (GRAS) as a sweetening agent for foods by the U.S. Food and Drug Administration. Ingestion of diet drinks containing low-calorie sweeteners might increase the risk of vomiting in breastfed infants. Some authors suggest that women may wish to limit the consumption of nonnutritive sweeteners while breastfeeding because their effect on the nursing infants are unknown.[1,2] Although risk to the breastfed infant appears to be low, an alternate artificial sweetener with more data available may be preferred, especially while nursing a newborn or preterm infant.

Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

A cross-sectional survey assessed the dietary history of US mothers nursing infants between 11 and 15 weeks of age. The survey was used to estimate the amount of diet soda and fruit drinks consumed by the women. There were no statistically significant differences in infants’ weight or z-scores based on low calorie sweetener exposure. However, infants exposed to low calorie sweetener in milk once or less per week had a statistically significantly higher risk of vomiting than those who were not exposed. Greater exposure was not associated with vomiting. It was not possible to assess the effects of specific sweeteners.[3]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Aspartame

References

1.

Sylvetsky AC, Gardner AL, Bauman V, et al. Nonnutritive sweeteners in breast milk. J Toxicol Environ Health A. 2015;78:1029–32. [PMC free article: PMC5583633] [PubMed: 26267522]

2.

Rother KI, Sylvetsky AC, Schiffman SS. Non-nutritive sweeteners in breast milk: Perspective on potential implications of recent findings. Arch Toxicol. 2015;89:2169–71. [PMC free article: PMC4749460] [PubMed: 26462668]

3.

Huang Q, Murphy J, Smith ER, et al. Diet beverage intake during lactation and associations with infant outcomes in the infant feeding practices study II. Nutrients. 2021;13:3154. [PMC free article: PMC8472746] [PubMed: 34579031] [CrossRef]

Substance Name

Stevia

Scientific Name

Stevia rebaudiana

CAS Registry Number

91722-21-3

Drug Class

Breast Feeding

Lactation

Plants, Medicinal

Sweetening Agents