Health Advisory: High Blood Lead Levels in Texas Children Consuming Recalled Cinnamon Applesauce Pouches

State health departments, the U.S. Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC) are investigating reports of children with high blood lead levels linked to certain fruit pouches containing cinnamon. In Texas, at least two children have been reported with high blood lead levels following consumption of the recalled cinnamon applesauce products. The Texas Department of State Health Services (DSHS) is advising healthcare providers to test children who have consumed the recalled products for lead exposure and is advising the public not to buy, eat, sell, or serve the recalled products because they may contain lead. Parents and caregivers of children who may have consumed recalled products should contact the child’s healthcare provider about getting a blood test for lead.

Recalled cinnamon apple puree and applesauce products with elevated levels of lead found in certain units of the product include:

• WanaBana Apple Cinnamon Fruit Puree pouches
• Schnucks brand cinnamon-flavored applesauce pouches and variety pack
• Weis brand cinnamon applesauce pouches

Some of the recalled products are sold nationally, including in Texas.

• WanaBana apple cinnamon fruit puree pouches are sold nationally through multiple retailers including Dollar Tree, Amazon, and other online outlets.
• Schnucks brand cinnamon-flavored applesauce pouches and variety pack are sold at Schnucks and Eatwell Markets grocery stores in Illinois, Indiana, Missouri, and Wisconsin.
• Weis brand cinnamon applesauce pouches are sold at Weis grocery stores in Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, and West Virginia.

More information about the specific recalled products may be found on the FDA’s website: Investigation of Elevated Lead Levels: Cinnamon Applesauce Pouches (November 2023) | FDA

There is no safe blood lead level. Lead can affect people of any age or health status. Children are more vulnerable to lead toxicity than adults because their nervous systems are still developing. Children also tend to absorb a higher proportion of ingested lead than adults.

Most children have no obvious immediate symptoms. If there is suspicion that a child may have been exposed to lead, parents should talk to their child’s healthcare provider about getting a blood test. Although lead can only be diagnosed through clinical testing, signs and symptoms of lead toxicity vary based on exposure.

Exposure to lead can result in the following symptoms:

• Fatigue
• Headache
• Irritability
• Nausea and vomiting
• Constipation
• Abdominal pain and cramps
• Weight loss
• Muscle and joint pain
• Tremor
• Damage to the brain and nervous system
• Slowed growth and development
• Learning and behavior problems
• Hearing and speech problems
• Difficulty concentrating

• Test all children who have consumed the recalled applesauce pouch product for lead exposure.
• Use the CDC blood lead value of 3.5 micrograms per deciliter (ug/dL) for case management and refer to the Reference for Blood Lead Retesting and Medical Case Management, Pb-109 form for appropriate follow-up actions.
• Refer to the Childhood Blood Lead Screening Guidelines, PB-120, for recommended blood lead testing for children, which includes testing of all Medicaid-enrolled children at ages 12 and 24 months, or at ages 24-72 months if not previously tested.
• Report all blood lead test results to DSHS as required by law. Reporting can be done electronically or by fax and should include complete demographic, testing, and provider information.
• Contact your local poison center at 1-800-222-1222 for advice on diagnosing and managing lead toxicity.

• Do not eat, sell, or serve recalled cinnamon-containing applesauce products because they may contain lead. These products should be discarded.  
• These products have a long shelf life. Consumers should check their homes and discard these products. 
• Most children have no obvious immediate symptoms of lead exposure. If there is a suspicion that a child may have been exposed to lead, including by eating one of the recalled produces, caregivers should talk to their child’s healthcare provider about getting a blood test. 
• Contact your healthcare provider if you think you may have symptoms of lead toxicity after eating the recalled fruit pouches.

• FDA investigation page
• CDC health advisory
• DSHS Blood Lead Surveillance Branch
• DSHS Environmental Lead Program
• CDC Childhood Lead Poisoning Prevention Program