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.