Artificial Sweeteners During Pregnancy: Safety Considerations
Most artificial sweeteners approved by the FDA are considered safe for moderate consumption during pregnancy, but some specific sweeteners like saccharin, cyclamate, and crude stevia leaf should be avoided during pregnancy due to potential risks.
FDA-Approved Sweeteners and Safety
The FDA has approved five nonnutritive sweeteners for use in the United States: acesulfame potassium, aspartame, neotame, saccharin, and sucralose. These sweeteners have undergone rigorous scrutiny and are generally considered safe when consumed by the public, including pregnant women 1.
Before being allowed on the market, all FDA-approved sweeteners must demonstrate safety for consumption by the general population, including during pregnancy 1.
For all food additives, including nonnutritive sweeteners, the FDA determines an acceptable daily intake (ADI), defined as the amount that can be safely consumed daily over a lifetime without risk 1.
Specific Recommendations During Pregnancy
Avoid saccharin during pregnancy as it can cross the placenta and remain in fetal tissues due to slow fetal clearance, though there is no definitive evidence of harmful effects 1, 2.
Avoid cyclamate and crude stevia leaf/extracts during pregnancy as these have not been adequately studied for safety in pregnancy 2.
Aspartame, sucralose, and acesulfame-K can be consumed in moderation during pregnancy, adhering to their acceptable daily intake levels 1, 2.
Recent research shows that artificial sweeteners (acesulfame, cyclamate, saccharin, and sucralose) can cross the placenta and are present in fetal circulation and amniotic fluid 3.
Potential Risks
A prospective cohort study of 59,334 Danish pregnant women found an association between intake of artificially sweetened carbonated and noncarbonated soft drinks and increased risk of preterm delivery 4.
High consumption of artificial sweeteners like sucralose, aspartame, and sodium saccharin has been linked to increased risk of gestational diabetes mellitus (GDM) in pregnant women 5.
In pregnant animal models, nonnutritive sweetener consumption has been associated with altered sweet taste preference later in life and metabolic dysregulations in offspring (e.g., elevated BMI, increased obesity risk, microbiome dysbiosis) 6.
Balanced Approach
Pregnant women should consume a balanced diet with sufficient protein (0.75 g/kg plus an additional 10 g/day) to support their health and their baby's development 7.
While artificial sweeteners may help reduce caloric intake, pregnancy is not a time for weight loss, so hypocaloric diets are not advisable 2.
Women with gestational diabetes or other specific health conditions should consult with their healthcare provider or nutritionist to determine the best dietary approach, including guidance on artificial sweetener consumption 7.
Practical Guidelines
Sugar alcohols (polyols such as erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, xylitol) are generally considered safe but may cause diarrhea, especially in children 1.
Moderation is key - actual intake of artificial sweeteners is typically much less than the ADI. For example, while the daily ADI for aspartame is 50 mg/kg body weight, the typical intake at the 90th percentile is only 2-3 mg/kg body weight 1.
For women concerned about weight gain during pregnancy, focus on overall balanced nutrition rather than simply substituting artificial sweeteners for sugar 2, 7.