Artificial Sweeteners During Pregnancy: Safety Considerations

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, which 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, as determined by the FDA 1, 2.
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, with examples including aspartame having a daily ADI of 50 mg/kg body weight 3.

The American College of Obstetricians and Gynecologists recommends avoiding 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 4.
Aspartame, sucralose, and acesulfame-K can be consumed in moderation during pregnancy, adhering to their acceptable daily intake levels, as recommended by the American Diabetes Association 5.

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, as recommended by the American College of Nutrition 6.
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, according to the American Diabetes Association 6.

Sugar alcohols (polyols such as erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, xylitol) are generally considered safe but may cause diarrhea, especially in children, as reported by the American Gastroenterological Association 1, 7.
Moderation is key - actual intake of artificial sweeteners is typically much less than the ADI, with the typical intake at the 90th percentile being only 2-3 mg/kg body weight for aspartame, as noted by the National Academy of Sciences 3.