Artificial Sweeteners and Pregnancy

There is a lot of concern about diet and nutrition during pregnancy.  One of these concerns is regarding artificial sweeteners and pregnancy. Should these sweeteners be used during pregnancy? Many women will cut sugar out of their diet, only to replace it with foods and drinks that are artificially sweetened.
These guidelines provide information from research done on the safety of these sweeteners. As with most things in pregnancy, it is always best to consult with your health care provider about what artificial ingredients are safe for you to use during your pregnancy.

Using Artificial Sweeteners During Pregnancy

Basic Information

Artificial sweeteners are ingredients that add sweetness to foods. Sweeteners are ingredients in soft drinks, desserts, candies, and pastries.  There are two categories of sweeteners: nutritive (contain calories) and non-nutritive (without calories).

Safety Considerations Artificial Sweeteners and Pregnancy

Nutritive sweeteners (such as table sugar) contain what is called “empty” calories. These additives contribute calories to the diet, but they contain few vitamins or minerals. When used in moderation, nutritive sweeteners are considered safe for consumption during pregnancy assuming they are not contributing to excess weight gain.
However, women with carbohydrate intolerance such as gestational diabetes, diabetes mellitus, or insulin resistance need to limit their use of nutritive sweeteners.

Nutritive sweeteners include sugars such as sucrose, dextrose, honey, corn sugar, fructose, and maltose. Sugar alcohols are also nutritive sweeteners that are often found in foods labeled as “sugar-free.” Technically, sugar alcohols are not sugars, but they do have calories which can be converted into fat.

Examples of sugar alcohols include Sorbitol, Xylitol, Isomalt, Mannitol, and Hydrogenated Starch.
Non-nutritive Sweeteners are added in very small amounts to foods for a significant sweetening effect and have been approved for use in dietetic or reduced-calorie foods and beverages. Research is limited on the safety of the use of non-nutritive sweeteners during pregnancy.

The following are non-nutritive sweeteners that are considered safe during pregnancy:

Rebaudioside A: (Stevia)

This is a new and common sweetener that is frequently used in soft drinks and juices. The FDA deems Stevia as safe during pregnancy; it has been given the GRAS (generally recognized as safe) rating by the FDA.

Acesulfame Potassium: (Sunett)

This sweetener is added to baked goods, frozen desserts, sugar-free gelatins, puddings, and beverages. Acesulfame Potassium has been deemed safe to use in moderation during pregnancy by the FDA.

Aspartame: (Equal or NutraSweet)

Aspartame is not effective in heat nor for long periods in liquid form. It is often found as an additive to soft drinks, gelatin, desserts, pudding mixes, breakfast cereals, beverages, chewing gum, dairy products, and other foods and drugs. According to the Food and Drug Administration(FDA), Aspartame is safe for use during pregnancy and lactation.
It is recommended to limit consumption to a moderate level.
Aspartame should not be used by anyone with PKU (a rare metabolic disorder), rare liver disease, or by pregnant women who have high levels of phenylalanine in their blood. Phenylalanine is a component of aspartame, and it may not metabolize correctly in anyone who has these conditions.

Sucralose: (Splenda)

This is a non-caloric sweetener that is made from sugar. Sucralose has been approved for use in baked goods, baking mixes, non-alcoholic beverages, chewing gum, coffee and tea products, confections and frostings, fats and oils, frozen dairy desserts and mixes, fruit juices, sugar substitutes, sweet sauces, toppings, and syrups. It can also be used as “table-top sweetener.”
Sucralose has no effect on blood sugar, offers no calories, and is deemed safe during pregnancy and lactation. According to the Food and Drug Administration (FDA), sucralose is safe for everyone to consume, including pregnant women.

Artificial Sweeteners that are NOT safe to use during pregnancy

Saccharin: (Sweet ‘N Low)

Although it is not used as much today as in the past, it still appears in many foods, beverages, and other substances. The FDA does consider saccharin to be safe to use for the general public. Former studies that had linked saccharin to an increased risk of developing bladder cancer have been dismissed by the National Toxicology Program.
But studies do show that saccharin crosses the placenta and may remain in fetal tissue, so its use for pregnant women still remains in question.

Cyclamate:

Cyclamate is currently banned for use in the U.S., and there is insufficient data regarding the safety of its use during pregnancy. If you use artificial sweeteners and are pregnant, it is always best to talk with your health care provider regarding which sweetener you use and how much you consume.
Last Updated: 07/2015

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Compiled using information from the following sources:
The Cleveland Health Clinic https://www.clevelandclinic.org/
U.S. Food and Drug Administration, https://www.fda.gov/
Weiner, C. P., & Rope, K. (2013). The Complete Guide to Medications During Pregnancy & Breastfeeding.