Is Stevia Safe During Pregnancy?

Once you get that positive pregnancy test, it's only natural to wonder what changes you need to make to your diet to keep yourself and your baby healthy. One topic that gets a lot of attention is sugar—especially since excessive sugar consumption during pregnancy has been linked to everything from preeclampsia to poor cognitive skills in kids.

But what about sugar alternatives like stevia? Does it behave the same way as sugar in your body? To find out the answers to these questions and more, we talked to several experts about the safety of consuming stevia during pregnancy. Here is what they had to say about the benefits and risks as well as any precautions you should take.

What Is Stevia?

Stevia is a sweetener that has become increasingly popular in the U.S. in the past few years. Made from the stevia plant native to Paraguay and Brazil, this low-calorie sweetener has been used by people in South America and Asia for centuries, not only to sweeten foods but also for medicinal purposes.

"Stevia, which is a sugar substitute, is 100 to 300 times the sweetness of sugar," explains Stuart Jones, MD, FACOG, an OB/GYN and attending physician at Avina Women’s Care. "It occurs naturally, unlike other sugar substitutes or artificial sweeteners."

When people are looking for a more natural option to replace other artificial sweeteners like aspartame, saccharine, and sucralose, they often turn to stevia. You may even see it used as a sweetener in some processed foods like chocolate, health bars, diet soda, and chewing gum, explains Shyamala Vishnumohan, PhD, APD, a food scientist, accredited practicing dietitian, certified prenatal dietitian, and founder of the One to One Thousand Nutrition Clinic.

"What makes stevia so interesting is that its sweetness comes from a group of compounds called steviol glycosides, which are sweeter than sugar but contain no calories and have negligible effects on blood sugar levels because of the low carb content," says Dr. Vishnumohan.

Is Stevia Safe During Pregnancy?

When considering whether or not to consume stevia in pregnancy, it is important to pay attention to the type of stevia before making a decision. In fact, the Food and Drug Administration (FDA) indicates that whole stevia leaves and stevia extracts are not safe for pregnant people (or others), but stevia sweeteners and foods sweetened with stevia are safe.

"Stevia has been given the GRAS [or generally recognized as safe] rating by the FDA," Dr. Jones says.

However, there are no specific guidelines for stevia consumption available for pregnant people, Dr. Vishnumohan adds. Instead, she suggests limiting sugar substitutes—especially because these sweeteners can influence the taste preferences of the fetus. Keep in mind, too, that the World Health Organization (WHO) recommends a daily upper limit of 4 mg of sugar substitutes per kilogram of body weight per day for anyone.

"The good news is that there is currently no evidence to suggest stevia is unsafe," Dr. Vishnumohan says. "But it is important to note that prenatal research to date has been exclusively animal studies, so more research is necessary to recommend the safety of consumption of stevia during pregnancy."

Benefits of Stevia During Pregnancy

One of the biggest benefits of stevia is that it provides options for people who have type 2 diabetes or those who are at risk of developing gestational diabetes when pregnant. In fact, leading health groups such as the Academy of Nutrition and Dietetics and American Diabetes Association support the safe use of low-calorie sweeteners during pregnancy. 

"One of the benefits of stevia is that it can be used by diabetics without causing increase in carbohydrate load and thus not increase blood glucose levels—which is the same either pregnant or non pregnant," Dr. Jones explains. "Like traditional sugar, stevia is heat stable and pH stable, so it can be used in cooking and baking, giving people other options for sweetening foods."

What's more, stevia's glycosides do not raise blood sugar levels, so stevia-sweetened drinks and desserts are suitable for anyone with diabetes, Dr. Vishnumohan adds. "The body does not extract any calories as the human body does not metabolize the sweet glycosides, and they pass through and are eliminated."

Risks of Stevia During Pregnancy

Even though stevia is recognized as generally safe during pregnancy, it is still important to use restraint when consuming it or adding it to foods. As with anything in pregnancy, moderation is always the best route, Dr. Jones says.

"Experts do not feel using stevia as a sweetener or to flavor foods will cause any adverse side effects," he says. "Some people can be gastric sensitive to stevia, and might experience cramping, bloating, and nausea—but this is rare."

Stevia also can act like a diuretic with the kidneys, Dr. Jones adds. Consequently, if you consume it in high doses—which would be more than typical flavoring or sweetening of food—you might experience dehydration or lower blood pressure. But, this is unlikely to occur with normal usage.

It is also important to remember that just because stevia originates from a plant, that does not mean you are purchasing a completely natural version in the store, Dr. Vishnumohan says. "You are buying a laboratory version, in which the sweetest components are extracted and dried into crystals. Food manufacturers often blend stevia with bulking agents like maltodextrin and other sweeteners to improve the texture and make it palatable, so be sure to read the label."

There also is a chance that artificial sweeteners can impact your gut microbiome, which is linked to immunity, weight regulation, mental health, and more, Dr. Vishnumohan adds. "But we don’t have any high-quality information on the impact of stevia, and the answer is not straight-forward since the evidence is incomplete."

Because clinical studies on the effects of sweeteners like stevia during pregnancy are limited, it is important to carefully consider how much you are eating each day. This approach is especially important if you have gestational diabetes and are watching your blood sugar levels.

"[Even though] stevia does not contain calories or cause fluctuations in blood sugar, it is important not to lose sight that other ingredients in the recipe can contribute to spikes in blood sugar," Dr. Vishnumohan adds.

What to Discuss With a Healthcare Provider

Whether you are in the beginning weeks of your pregnancy or entering your third trimester, eating a balanced diet is the best approach to keeping your body healthy and preparing an optimal environment for your baby.

If you are unsure how to address your nutritional needs during pregnancy, or if you are not sure if stevia-sweetened treats are right for you, it it important to talk to a healthcare provider about your concerns. Not only can they provide you with guidance given your medical history and nutritional needs, but they also can connect you with a prenatal dietitian for further direction if needed.

No matter your situation, it is always a wise approach to limit stevia-sweetened foods in pregnancy, Dr. Vishnumohan says. "For a sweet treat go for the real deal—use a banana or dates to sweeten your dessert. Swap diet soda for lemon slices in sparkling water. Even unsweetened Greek yogurt topped with berries and dark chocolate (85% cocoa) can taste sweet. Give it time. Your taste buds will recalibrate and your gut microbes will thank you."