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Birch's sap is given by Tree Father Birch to use in the Oasis quest to stop Harold, the FEV victim with a tree growing out of his head, from growing beyond Oasis and entering the Capital Wasteland. If the quest is completed in Leaf Mother Laurel's favor, this item can either be kept or used as Rock-It Launcher ammunition.
Though it no longer serves any purpose, this item is still found in the game files for Fallout: New Vegas.