Stevia

Stevia is not recommended for babies and toddlers. It should not be given before 24 months, and then only in very limited amounts.

Where it comes from

Stevia rebaudiana, known locally as ka'a he'e, is a shrub native to a very small region of South America. Its leaves hold naturally sweet, sugar-free glycosides. It is now grown in many parts of the world. Steviol glycoside extracts from the leaves are 200 to 400 times sweeter than table sugar. In the US only the purified extract is approved as a food additive, not the whole leaf.

Safety

Purified steviol glycoside extract is generally regarded as safe by the FDA. More research is needed on its long-term effects in babies and young children, though. Even in adults, large amounts can cause headache, dizziness, numbness, nausea, and in some people lower appetite.

Do not give stevia before 12 months. We also advise against it between 12 and 24 months, because sugar alternatives may affect a child's taste perception and lessen willingness to try new foods.

After the first birthday a small amount of sweetened food is generally considered acceptable, though waiting on sugar and other sweeteners until the second birthday is ideal.

From 24 months, after weighing the effect on the diet and the possible side effects, you may add a very small amount of stevia to baked goods, herbal teas without caffeine, and other foods. The joint FAO and WHO expert committee on food additives sets the daily limit it considers safe for steviol glycosides at 4 mg per kilogram of body weight.

If you want to sweeten food, use banana, apple, or another naturally sweet, fiber-rich fresh fruit.

Stevia itself is not a common choking hazard. The foods that contain it can be.

Set up a safe eating space and stay beside your baby.

Stevia is not a common allergen. Allergy to it is rare but has been reported. The already low number of documented reactions dropped sharply after 2008, when highly purified products became common.

Related conditions

People allergic to ragweed pollen and people with oral allergy syndrome (pollen-food allergy syndrome) may be oversensitive to stevia. That means short-lived itching and burning in the mouth, with no dangerous reaction expected.