daily vitamin A requirement (the Recommended Daily Allowance or RDA). As such, the use of Sprinkles as
‘home fortification’ is complementary to the high dose vitamin A capsules, not competitive. When the WHO
initiated the high dose capsules, they did not stipulate that the child receiving the supplement should not
eat food containing vitamin A. Indeed, they recommended an age-appropriate diet which would contain all
micronutrients, including vitamin A.
Sprinkles with vitamin A is formulated to help children meet their RDA for vitamin A and thus is safe to use with the high dose supplement.
hy does this happen? Is it of any significance?
consistency of their stools. The colour of the stool will change to a dark or black colour in all infants
if they are receiving the Sprinkles on a regular basis. The dark colour is a result of the ‘unabsorbed’
iron being excreted in the stool. Iron itself is dark in colour, thus unabsorbed iron will darken the stool.
Some very young infants, who have not previously been exposed to any complementary foods containing micronutrients
(i.e. who are exclusively breast-fed) may develop loose stools or even mild diarrhea. The diarrhea does not lead to dehydration, but is a valid concern to parents and health care providers. The diarrhea seems to last for about a week and then will not recur. Parents have reported to us that if they use 1/3 – 1/2 of a package of Sprinkles added to complementary foods in young infants who are starting the transition from breastfeeding to complimentary feeding, the diarrhea quickly disappears. Others use 1/3 of a package at each meal with similar outcomes.
We are not sure about the etiology of the loose stool, but it may be due to the change in bowel flora associated
with the introduction of iron into the diet or possibly the impact of ascorbic acid on bowel peristalsis in infants who previously had received only very small amounts of ascorbic acid in their diets (in breast milk).
Since the loose stoolhas only been observed in infants when they are beginning the process of transition from
exclusive breastfeeding to a diet of complementary feeds, it is possible that the loose stoolis unrelated to
the Sprinkles, but is more related to the change in stool pattern with the introduction of complementary
(to mask the metallic taste), it will float to the top of liquids and tend to stick to the side of the cup
or glass. So, although Sprinkles can be used with any fluid, some will be lost in the process.
Thus Sprinkles are safe to use, even in infants without micronutrient deficiencies. In fact, Sprinkles were originally designed to prevent deficiencies in non-deficient children at risk of micronutrient deficiencies.
older children, adolescents, adults and pregnant women?
Infants and young children cannot safely ingest tablets or pills. Syrups and drops have been used for many
years, but compliance has been documented to be poor (for iron) because of the strong unpleasant taste of
the drops; the drops tend to stain the teeth unless they are carefully placed at the back of the infants’
mouth; and for parents who cannot read, it is often difficult to measure the appropriate amount of liquid
iron which is often supplied in a bottle with a dropper calibrated in milliliters. In addition, although
general food fortification is an excellent way to prevent micronutrient deficiencies in adults, because
children ingest smaller amounts of foods than do adults, general fortification often will not meet the
micronutrient needs of young children. Thus, Sprinkles occupies a unique niche for young children. For other age groups, there are more choices for supplementation, including the use of fortified foods, pills and capsules. Nevertheless, Sprinkles can be used in these other age groups without fear of toxicity.
To date, our research emphasis has focused on infants and children under aged 5 years, however we have ongoing research involving pregnant women.
the food into which it is added. However, some parents have noticed a change in the taste and colour of the food. Can this be explained?
with a thin coat of a soy lipid. The melting temperature for the lipid is around 60ºC. If Sprinkles are
added to food that is hotter than 60ºC, the lipid coating around the iron will melt and the food will be
exposed to the iron. The result will be that the iron can change the colour of the food and certainly will have a strong taste.
To prevent changes in the taste and the colour of food to which Sprinkles is added, we recommend that Sprinkles be added to the food after it is cooled to a temperature below 60ºC.
source of Sprinkles available is from the Hospital for Sick Children Specialty Food Shop
(http://www.sickkids.on.ca/specialtyfoodshop) and is only available in North America, however Sprinkles are available for use by governments, U.N. agencies and non-governmental organizations who provide Sprinkles on a humanitarian basis to populations in need.
Ped-Med Ltd is owned by Stanley Zlotkin, the inventor of Sprinkles. The objective of maintaining the
intellectual property associated with Sprinkles is to ensure the highest standards of quality and integrity
to the Sprinkles Initiative and to ensure the safety and efficacy of Sprinkles to the end users.
The name Sprinkles is protected as a trademark. Only approved suppliers of Sprinkles are granted use of the
Sprinkles technology and use of the Sprinkles name as a quality mark to represent production under the highest
quality standards and commitment to the Sprinkles Initiative.
last until 6 months of age. Sprinkles may be given once complementary foods are started. Infants should
receive a minimum of 60 sachets, either once daily, or 60 sachets over 90 120 days. The provision of 60
sachets should be repeated yearly until a variety of mixed foods (containing iron and other micronutrients)
are being eaten.
as adherence to treatment remained poor. They called for a simple, inexpensive and potentially viable
new method to provide micronutrients (including iron) to populations at risk. The Sprinkles concept was
based on two observations from the ‘West’ where micronutrient deficiencies are rare; (a) fortification of
commercially available food provides essential micronutrients and (b) no change in the color, texture or
taste of the food ensures compliance.
Responding to the challenge, the Sprinkles Global Health Initiative at The Hospital for Sick Children,
University of Toronto, developed Sprinkles utilizing encapsulated iron that could be added directly to food.
blend (CSB) or wheat-soya blend (WSB), two vehicles suitable for the addition of Sprinkles. Both these rations
produce a thick paste-like substance after cooking, to which Sprinkles may be added after cooling to provide an additional source of micronutrients. Sprinkles has been used in emergency relief aid in Indonesia and Haiti.