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Are Artificial Sweeteners Safe in Pregnancy and During Breastfeeding?

Low or no calorie sweeteners are common.  They are present in soft drinks and many other foods to replace sugar and other high caloric sweeteners in efforts to aid in weight loss or help control diabetes. Artificial sweeteners are on every restaurant table to add to your coffee or tea as an alternative to sugar. 

What are artificial sweeteners?

Artificial sweeteners (or sugar substitutes) are considered food additives and are under strict control by Health Canada through the Food and Drug Regulations.  They are considered safe for consumption at or below the acceptable daily intake (ADI).

There are currently the following artificial sweeteners approved for use in Canada:

  • Acesulfame potassium
  • Advantame
  • Aspartame (Nutrasweet®, Equal®)
  • Monk fruit extract
  • Neotame
  • Saccharin
  • Sucralose (Splenda®)
  • Sugar alcohols (ex. sorbitol, xylitol, or erythritol)
  • Stevia
  • Thaumatin

Safety of artificial sweeteners

When used in moderation and within Health Canada’s recommendations for acceptable daily intake (ADI), artificial sweeteners are considered safe for use in pregnant and breastfeeding women.  

Aspartame should be avoided by people with an inherited genetic disorder called phenylketonuria.  All products with aspartame are labeled that they contain phenylalanine so they can be avoided by those people.

Saccharin was previously thought to cause cancer, but scientific research has proven this theory incorrect.  As such, saccharin has been approved for use in Canada.  

Another artificial sweetener called cyclamate (Sugar Twin®, Sweet N’Low®, Weight Watchers Table Top Sweetener®) is only approved for sale as a non-food item and cannot be used as a food additive in Canada.  It must be labeled with a cautionary statement ““this sweetener should be used only on the advice of a physician”.  Cyclamate should NOT be consumed by a pregnant woman.  It is currently banned for use in the United States. It is not clear if cyclamate is safe for use in women who are breastfeeding. 

Personally, I limit my use of artificial sweeteners given that there has been some controversy on their safety over the years. Also, there continues to be emerging research in the area of artificial sweeteners and diabetes.

It is also important to consider that both pregnant and breastfeeding women have higher energy requirements in order to sustain the growth of the baby and production of breast milk.  Use of sugar substitutes should not replace foods needed for a health pregnancy or breastfeeding mother.  Speak to your physician or a Registered Dietician if you have concerns about your weight during or after your pregnancy.

This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.


Pope E, Koren G, Bozzo P. Sugar substitutes during pregnancy. Can Fam Physician. 2014;60(11):1003–1005.

La Vecchia C. Low-calorie sweeteners and the risk of preterm delivery: results from two studies and a meta-analysis. J Fam Plann Reprod Health Care. 2013;39(1):12–3.

Sylvetsky AC, Gardner AL, Bauman V et al. Nonnutritive sweeteners in breast milk. J Toxicol Environ Health A. 2015;78:1029-32. 

Rother KI, Sylvetsky AC, Schiffman SS. Non-nutritive sweeteners in breast milk: Perspective on potential implications of recent findings. Arch Toxicol. 2015;89:2169-71

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