Micronutrient Sprinkles is a new 'home-fortification' approach to deliver iron and essential micronutrients to young children. To compare the difference between daily and flexible administration on hematological impact, adherence and acceptability in a rural setting, 362 children with hemoglobin concentrations (Hb) ≥ 70g/L were randomized to receive 60 sachets (12.5mg Fe each) of Sprinkles daily over 2 months, or flexibly over 3 or 4 months. Mean Hb improved significantly by 11g/L, 13g/L and 17g/L in daily-2-month, flexible-3-month and flexible-4-month groups, respectively. Mean Hb increase and anemia cure rate was greater with the flexible-4-month regimen than daily (P<0.01). Overall anemia prevalence decreased significantly by 51% among groups. Mean adherence was highest in flexible-4-month group (98%) compared to daily-2-month (88%) and flexible-3-month (93%) groups ( P<0.01). The flexible administration of Sprinkles was preferred over daily by caregivers. Flexible administration of 60 Sprinkles sachets over 4 months is more effective to control childhood anemia.