(NEW YORK) — The issue was first brought to the FDA’s attention when health officials in North Carolina were investigating elevated blood lead levels in four children and found that the WanaBana apple cinnamon pouches could be the common source.

The North Carolina Department of Health and Human Services (NCDHHS) subsequently analyzed “multiple lots” of the WanaBana apple cinnamon fruit puree pouches and detected “extremely high concentrations of lead,” according to the FDA warning.

“The FDA has reviewed and supports NCDHHS’s analytical findings and found that analytical results at this level could result in acute toxicity,” the FDA advisory declares, adding that they shared the findings with WanaBana, which has “agreed to voluntarily recall all WanaBana apple cinnamon fruit puree pouches regardless of expiration.”

The products were sold at retailers including Sam’s Club, Amazon and Dollar Tree.

“Parents and caregivers of toddlers and young children who may have consumed WanaBana apple cinnamon fruit puree pouches should contact their child’s healthcare provider about getting a blood test,” the FDA urged.

Experts say it can be difficult to detect lead exposure in kids, because sometimes there are no obvious signs. However, the FDA says symptoms of short-term lead exposure can include headache, abdominal pain and vomiting, with longer-term exposure symptoms also potentially including fatigue, irritability, constipation, muscle aches or a sensation of prickling/burning, and more.

Lead exposure can only be properly diagnosed via a blood sample, according to the Centers for Disease Control and Prevention. The FDA says anyone who notices possible lead poisoning symptoms should contact their doctor immediately.

“No safe blood lead level in children has been identified,” according to the CDC . “Even low levels of lead in blood have been shown to negatively affect a child’s intelligence, ability to pay attention, and academic achievement,” the agency stated, adding that lead exposure happens when a child contacts it by “touching, swallowing, or breathing in lead or lead dust.”

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