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FAQ: MixMe® Vitamin and Mineral Powder

1. What is MixMe® Vitamin and Mineral Powder?

  • MixMe® Vitamin and Mineral Powder are foil sachets filled with a dry powder mixture containing 15 essential vitamins and minerals that are often missing in the diets of children from 6 months to 59 months (5 years).
  • The Vitamin and Mineral Powder is also sometimes referred to as multiple MicroNutrient Powder (MNP).

IMPORTANT TO NOTE:

  • All children should be exclusively breastfed (breast milk only without any other fluids, not even water) from birth to 6 months of age.
  • (Semi-)solid complimentary foods are added at 6 months of age together with continued breastfeeding for up to 2 years and beyond.

2. What does MixMe® Vitamin and Mineral Powder contain?

Composition per 1g sachet: 1 serving:
Nutrient Per 1g Serving %RNI’s*
Vitamin A
1332 IU / 400 mcg 100
Vitamin D
200 IU / 5 mcg 100
Vitamin E
5 mg TE 100
Vitamin B1
0.5 mg 100
Vitamin B2
0.5 mg 100
Vitamin B6
0.5 mg 100
Vitamin B12
0.9 mcg 100
Niacinamide
6 mg 100
Folate 150
mcg 100
Vitamin C
30 mg 100
Iron
10 mg 100
Zinc
4.1 mg 100
Copper
0.56 mg 100
Selenium
17 mcg 100
Iodine 90 mcg 100
  • The composition is based on the Recommended Nutrient Intake (RNI) of each micronutrient per dose for children 6 – 59 months of age as per the WHO/UNICEF/WFP Joint Statement Document 6-59 months (2).
  • Recommended Nutrient Intake (RNI) is defined by the World Health Organisation (WHO) and Food and Agriculture Organisation (FAO) as the daily dietary intake of a nutrient sufficient to meet the requirements of nearly all apparently healthy individuals in a specific population group (3).

Peptides

  • Inactive ingredients included in MixMe® Vitamin and Mineral Powder are: maltodextrin, silicon dioxide, tricalcium phosphate and are used to act as carriers for the vitamins and minerals.

3. Why use MixMe® Vitamin and Mineral Powder?

  • Often the foods fed to children when they transition from exclusive breastfeeding (0 - 6 months) to family foods, from 6 - 59 months of age, do not provide enough of the vital vitamins and minerals to meet their daily needs.
  • Adding MixMe® Vitamin and Mineral Powder to the food of a child, between 6 months and 25 years of age, just before it is fed to the child, ensures an adequate intake of the essential vitamins and minerals.
  • Adding MixMe® Vitamin and Mineral Powder to the food of children, between the ages of 6 months and 5 years, at home (home fortification) aims to ensure that the foods that they eat, meets their needs for the essential vitamins and minerals.
  • Children from birth to 6 months should be exclusively breastfed and children between 6 months and at least 2 years of age, should continue to be breastfed.

4. What are the benefits of using MixMe®?

  • Many studies have shown that MixMe® Vitamin and Mineral Powder helps to ensure that children, between the age of 6 months to 5 years, receive the vital vitamins and minerals that they need for their health, growth and development.
  • MixMe® Vitamin and Mineral Powder contains 15 essential vitamins and minerals and using MixMe® Vitamin and Mineral Powder each day, allows you to feel confident that your child aged from 6 months to 5 years is getting the vitamins and minerals they need.
  • Home fortification increases micronutrient intake, which leads to an improvement of micronutrient status and can therefore improve child health, including:
    - morbidity and mortality
    - improved growth
    - improved cognition
    - improved appetite and other functional outcomes (4)

5. Who should use MixMe® Vitamin and Mineral Powder?

Target group:
  • MixMe® Vitamin and Mineral Powder is recommended for infants and children 6 – 59 months (6 months to 5 years) of age. Home fortification
    should start when complimentary foods are introduced to the diet together with continued breastfeeding to 2 years of age and beyond.
    Home fortification may be continued when family foods are introduced to older children.
  • The period of highest vulnerability for micronutrient deficiencies in young children is from 6 – 23 months of age, when food quantity and variety
    may be limited (4).
  • Children from 24 – 59 months of age may however also be at high risk of inadequate dietary intake of some vitamins and minerals (4).

Target Health Conditions:

  • The health issues most commonly targeted for the use of MNP’s are:
  1. Anaemia (According to WHO 2011 guideline, products aimed at reducing anaemia should contain at least 3 micronutrients, including iron, vitamin A and zinc) (5).
     
  2. General dietary micronutrient inadequacies in addition to anaemia (According to WHO/FAO guidelines 2007 products aimed at reducing micronutrient deficiencies - should contain at least 15 micronutrients) (3).
  • MixMe® Vitamin and Mineral Powder contains 15 micronutrients including iron (10mg per sachet), vitamin A (1332 IU/ 400 mcg per 1g sachet) and zinc (4.1 mg per 1g sachet).

6. How often should MixMe® be used?

7. How should MixMe® be used?

For one child, mix one sachet of MixMe® Vitamin and Mineral Powder per day with the food that the child is being fed at a
single meal.
  • MixMe® Vitamin and Mineral Powder SHOULD NOT be used for
    infants under 6 months of age, as these children only need breast
    milk and should be exclusively breast-fed.
  • Avoid sharing a sachet of MixMe® Vitamin and Mineral Powder with
    other children. This is because one sachet contains the vitamins and
    minerals that one child needs.
  • Put the child’s food on their own separate plate
MixMe Step 1
   
Mix the MixMe® Vitamin and Mineral Powder into warm, solid or semi-solid foods just before feeding the child aged between 6 months and 5 years.
  • MixMe® Vitamin and Mineral Powder SHOULD NOT be added before cooking as this will destroy the vitamins and minerals.
  • MixMe® Vitamin and Mineral Powder SHOULD NOT be added to very hot foods as it could result in colour and taste changes.
  • MixMe® Vitamin and Mineral Powder SHOULD NOT be added to cold foods as the powder may not mix well and result in lumps.
  • MixMe® Vitamin and Mineral Powder SHOULD NOT be added to
    liquid foods as it could result in colour and taste changes.
  • MixMe® Vitamin and Mineral Powder is used added to foods, TOGETHER WITH continued breast feeding for children 6 months up to at least 2 years and DOES NOT replace breast milk. Children from birth to 6 months should be exclusively breastfed.
MixMe Step 2
   
Mix the MixMe® Vitamin and Mineral Powder into the amount of food which the child will eat at one time.
  • Choose the meal where the child eats the most.
  • The contents of the MixMe® Vitamin and Mineral Powder sachet should be used all at once at one meal and SHOULD NOT be divided between meals, as the vitamins and minerals in the open powder might become inactive.
MixMe Step 3
   
Food mixed with MixMe® Vitamin and Mineral Powder should be fed to a child within half an hour (30 minutes) of mixing. If the child does not eat all the food to which the MixMe® Vitamin and Mineral Powder has been added, that food should be thrown away and not kept for another meal. This is to ensure that the vitamins and minerals remain active.
  • MixMe® Vitamin and Mineral Powder does not change the taste or consistency of the food when mixed correctly. The colour of white / beige foods such as maize porridge could change to a slightly yellow colour when MixMe® Vitamin and Mineral Powder is added. No colour changes are normally seen in darker foods such as stews and gravy.
    MixMe® Vitamin and Mineral Powder contains iron and so children using a Micronutrient Powder may have a darker or even black stool. This is not cause for concern.
MixMe Step 4

8. Have any side effects been reported from using MixMe® Vitamin and Mineral Powder?

  • Although occurring in less than 1% of those using MNP’s, mild diarrhoea may occur when children start using a vitamin and mineral powder. This usually stops within 2 days. Where diarrhoea does occur, it should be treated following the standard protocol and with increased liquids. MixMe® Vitamin and Mineral Powder consumption does not need to be interrupted (4).
  • If the diarrhoea continues for longer than 2 days, is severe, or is bloody or contains mucous, the child should see a Healthcare Professional (4).
  • MixMe® Vitamin and Mineral Powder contains iron, thus children using a Micronutrient Powder may have a darker or even black stool. This is not cause for concern as darker stools are due to the fact that the iron is being absorbed into the child’s body. Caregivers may need to be informed of this possibility.

9. Can MixMe® Vitamin and Mineral Powder be provided in combination with other fortified products and supplements, such as:

a. High-dose vitamin A capsules (VAC)
b. Iodised salt
c. General food fortification of flour, maize meal, oil, salt, etc.
d. Specially formulated products (LNS, RUTF, CSB+/++, WSB+/++, RUSF, etc.)
  • MixMe® Vitamin and Mineral Powder can be safely provided in addition to twice-yearly high-dose VAC, iodised salt and general food fortification.
  • Combining it with other specially formulated products, such as RUTF (Ready-to-Use Therapeutic Foods) for treatment of severe acute malnutrition, RUSF (Ready-to-Use Supplementary Foods) or fortified blended foods such as WSB++ (Wheat-Soy Blend) or CSB++ (Corn-Soy Blend) for treatment of moderate acute malnutrition, or small quantity LNS (Lipid-based Nutrient Supplement, <= 20g/d, providing <=120 kcal/d) is not appropriate because these products already contain a similar or higher amount of micronutrients. In that case, one can recommend keeping MixMe® Vitamin and Mineral Powder for later, when these other products are no longer required.

10. Can MixMe® Vitamin and Mineral Powder be used in malaria areas?

  • In malaria-endemic areas, the provision of iron-containing Vitamin and Mineral Powder should be implemented in conjunction with measures to prevent, diagnose and treat malaria.

11. Why MixMe® Vitamin and Mineral Powder is not encouraged to be mixed with liquid or hot food?

  • In order to mask the strong metallic taste of the iron, the iron in MixMe® Vitamin and Mineral Powder is coated or encapsulated with a thin coat of soy lipid (to mask the metallic taste). When it is mixed with liquid foods, it will float to the top of liquids and tend to stick to the side of the cup or glass, so some of the powder will be lost.
  • The melting temperature for the lipid is around 60°C. If MixMe® Vitamin and Mineral Powder is added to food that is hotter than 60°C, the lipid coating around the iron will melt and the iron will be exposed to the food. The result will be that the iron may change the colour of the food and certainly will cause a stronger taste.
  • To prevent changes in the taste and the colour of food to which MixMe® Vitamin and Mineral Powder is added, it is recommended that MixMe® Vitamin and Mineral Powder be added to food after it is cooled to a temperature below 60°C or once it is ready to be eaten by a child (warm foods).

12. How should MixMe® Vitamin and Mineral Powder be stored?

  • Store below 25°C, in a cool, dry place.
  • Protect from sunlight. Store the large foil pouch with the sachets in a cool place like a cupboard or shelf away from the sun and heat. Some
    vitamins and minerals will lose activity if they are exposed to heat or sunlight
  • Shelf life: Recent research shows that the 1g sachets can be stored for at least 24 months at 30°C. Look at the expiry date indicated on the back of the pack and sachets.
  • KEEP OUT OF REACH OF CHILDREN.
  • Packaging can be recycled or should be buried - do not burn packaging.

 

 

 

 
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