毒理性
哺乳期间使用的总结:甜叶菊(Stevia rebaudiana)叶含有甜菊糖苷和莱鲍迪苷。尽管研究结果不一,甜叶菊叶已被研究用于治疗糖尿病和高血压。甜叶菊对哺乳没有特定的用途。目前没有关于甜叶菊成分排入母乳或甜叶菊在哺乳母亲或婴儿中的安全性有效性的数据。甜菊糖苷A被美国食品药品监督管理局(FDA)认为是食品中的一种“普遍认为安全”(GRAS)的甜味剂。摄入含有低卡路里甜味剂的饮食饮料可能会增加哺乳婴儿呕吐的风险。一些作者建议,由于对哺乳婴儿的影响未知,妇女可能希望在哺乳期间限制非营养性甜味剂的使用。尽管对哺乳婴儿的风险似乎较低,但可能更愿意选择有更多数据可查的其他人造甜味剂,特别是在哺乳新生儿或早产儿时。
膳食补充剂不需要美国食品药品监督管理局的广泛市场前批准。制造商负责确保产品的安全性,但在上市前不需要证明膳食补充剂的安全性和有效性。膳食补充剂可能含有多种成分,标签和实际成分或其含量之间通常存在差异。制造商可以与独立组织签订合同,以验证产品或其成分的质量,但这并不证明产品的安全或有效性。由于上述问题,一个产品的临床测试结果可能不适用于其他产品。关于膳食补充剂的更详细信息可以在LactMed网站的其它地方找到。
对哺乳婴儿的影响:一项横断面调查评估了美国母亲在婴儿11至15周大时哺乳的饮食史。该调查用于估计妇女摄入的无糖苏打水和果汁饮料的量。根据低卡路里甜味剂暴露,婴儿的体重或z得分没有统计学上的显著差异。然而,每周一次或更少接触低卡路里甜味剂牛奶的婴儿比那些没有接触的婴儿有统计学上显著更高的呕吐风险。更多的暴露与呕吐无关。无法评估特定甜味剂的影响。
对泌乳和母乳的影响:截至修订日期,没有找到相关的已发布信息。
◉ Summary of Use during Lactation: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. 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.
◉ Effects in Breastfed Infants:A cross-sectional survey assessed the dietary history of US mothers nursing infants between 11 and 15 weeks of age. The survey was used to estimate the amount of diet soda and fruit drinks consumed by the women. There were no statistically significant differences in infants’ weight or z-scores based on low calorie sweetener exposure. However, infants exposed to low calorie sweetener in milk once or less per week had a statistically significantly higher risk of vomiting than those who were not exposed. Greater exposure was not associated with vomiting. It was not possible to assess the effects of specific sweeteners.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)