About Thickening Liquids

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Time to Read: About 4 minutes

This information explains how and why to thicken your liquids. It also lists liquids to include and avoid for people who can only have thick liquids.

Why do I need to thicken my liquids?

You may need to thicken your liquids if you have dysphagia (dis-FAY-jee-uh). Dysphagia is when you have trouble chewing or swallowing. Thicker liquids lower your risk of choking or coughing on the liquids you drink.

Thin liquids, such as water and milk, flow down your throat quickly. This can make them unsafe. Thicker liquids go down your throat more slowly. This makes them easier to control and safer to swallow. It also lowers your risk of choking or coughing on the liquids you drink.

How do I thicken my liquids?

You will add an ingredient to liquids called a thickener. SimplyThick® and Thick and Easy® are examples of thickeners.

There are different thickness levels. Your speech language pathologist will tell you which thickness level is right for you. Write your thickness level on the line below.

If you have questions or want to make an appointment with your speech language pathologist, call 212-639-5856.

Where can I buy a thickener?

You can buy a thickener at your local pharmacy (such as Walgreens or CVS) or online (such as on Amazon). You do not need a prescription.

How much thickener will I need to add to my liquids?

Liquids need different amounts of thickener. For example, some shakes may be the right thickness already. But you may need to add thickener to other drinks to make them the right thickness. Follow the directions that come with the thickener product.

Make sure to thicken your liquids to the level your care team recommends. Follow the instructions in the “How can I check the thickness of my liquids?” section. to make sure they’re thickened to the right level.

Can I add thickener to any liquid?

No. Foods that become thin liquids at room temperature cannot be thickened. Here are some examples.

  • Ice cream
  • Frozen yogurt
  • Sherbet
  • Slushy drinks
  • Gelatin, such as Jell-O®

What are the different levels of liquid thickness?

The International Dysphagia Diet Standardisation Initiative (IDDSI) made a scale for describing the thickness of liquids. Your speech language pathologist will tell you how thick to make your liquids. Here are the different thickness levels.

Level 1: Slightly thick

These liquids:

  • Are a little thicker than water.
  • Can be sucked through a standard straw easily.

Level 2: Mildly thick

These liquids:

  • Can be sipped from a cup.
  • Can be sucked through a standard straw with some effort.

Level 2 liquids used to be called nectar thick liquids.

Level 3: Moderately thick

These liquids:

  • Can be sucked through a wide straw with some effort.
  • Take a little more time to swallow. Your tongue will need to hold the liquid in your mouth before you swallow it.
  • Are drinkable with a cup or a spoon.

Level 3 liquids used to be called honey thick liquids.

How can I check the thickness of my liquids?

You can check the thickness of your liquids by doing a flow test. Follow these steps to do a flow test. Make sure to check the thickness of each liquid you drink.

  1. Get your supplies. You will need:
    • 2 (10 milliliter (mL)) syringes
    • A stopwatch, timer, or watch. You can use the timer on your smart phone.
  2. Take the plunger out of 1 syringe.
  3. Cover the end of the syringe with your finger.
  4. Fill the syringe with 10 mL of your liquid. You can use the other syringe to do this more easily.
  5. Take your finger off the end of the syringe and start your stopwatch at the same time.
  6. Wait 10 seconds, then put your finger back on the end of the syringe to stop the liquid from flowing out.
  7. Check to see how much liquid is still in the syringe.
    • The liquid is level 1: slightly thick if there is 1 to 4 mL in the syringe after 10 seconds.
    • The liquid is level 2: mildly thick if there is 4 to 8 mL in the syringe after 10 seconds.
    • The liquid is level 3: moderately thick if there is 8 mL or more in the syringe after 10 seconds.
Steps to do an IDDSI flow test

What can I drink on a diet of thick liquids only?

Your speech language pathologist may recommend you follow a thick liquid only diet. This means it is not safe to have thin liquids, regular food, soft food, or pureed food. Your speech language pathologist will tell you how thick to make your liquids.

Here are some drinks to include and avoid while following a thick liquid only diet. Remember to check the thickness of your liquids with the flow test.

Milk and dairy

Milk and dairy to includeMilk and dairy to avoid
  • Thickened milk.
  • Thickened non-dairy milks, such as almond and oat milk.
  • Thickened milkshakes.
  • Thickened eggnog.
  • Thickened liquid nutritional supplements, such as Carnation Breakfast Essentials® and Ensure®.
  • All others, including milk and milkshakes that are not thickened.
  • All ice cream, frozen yogurt, and gelato.
  • All liquid nutritional supplements that are not thickened.
  • Yogurt, custard, and pudding.
  • Cheeses.

Meats and meat substitutes

Meats and meat substitutes to includeMeats and meat substitutes to avoid
  • No meats or meat substitutes.
  • All meats and meat substitutes.

Breads and cereals

Breads and cereals to includeBreads and cereals to avoid
  • Cooked and strained hot cereals (such as oatmeal, Cream of Wheat®, and Cream of Rice®). Add liquid, such as water or milk, to thin it to your thickness level.
  • All other breads and cereals.

Soups

Soups to includeSoups to avoid
  • Thickened broth or bouillon.
  • Thickened, strained, and pureed vegetable soups and cream soups.
  • All other soups, including soups with chunks of meat, vegetables, and other soft solid pieces, such as pasta and rice.
  • Soups and broths that are not thickened.

Fats

Fats to includeFats to avoid
  • Melted butter, margarine, cream, and oils used in cooking and blended in thickened liquids.
  • All other fats.

Drinks

Drinks to includeDrinks to avoid
  • Thickened coffee.
  • Thickened tea.
  • Thickened water.
  • Thickened carbonated (fizzy) drinks.
  • Thickened hot chocolate.
  • Other liquids with thickener added.
  • All drinks that are not thickened.

Fruits

Fruits to includeFruits to avoid
  • Thickened nectars.
  • Thickened juices.
  • All fruit juices and nectars that are not thickened.

Vegetables

Vegetables to includeVegetables to avoid
  • Thickened vegetable juices, such as V8 Splash® or tomato juice.
  • All vegetable juices that are not thickened.

Sweets and desserts

Sweets and desserts to includeSweets and desserts to avoid
  • Syrups and sugar blended in other foods.
  • Gelatin, such as Jell-O®.
  • Sorbet.
  • Sherbet.
  • Fruit ices.
  • Popsicles.
  • All other sweets and desserts.

Other

Other things to includeOther things to avoid
  • None.
  • Avoid spicy and acidic foods if you have mouth sores.

Sample menu for a thick liquid only diet

Use this sample menu to get ideas for making your own meals when following a thick liquid only diet.

Thick liquid only diet menu
Breakfast
  • Hot cereal, such as Cream of Wheat® with thickened milk
  • A glass of thickened juice
  • A cup of thickened coffee
Mid-morning snack
  • Thickened Ensure®
Lunch
  • Thickened soup consommé
  • A glass of thickened water
  •  A cup of thickened tea
Mid-afternoon snack
  • A glass of thickened milk
Dinner
  • Thickened cream soup
  • A glass of thickened juice
  • Thickened Carnation Breakfast Essentials®
Evening snack
  • Thickened eggnog

Contact information

If you have questions or want to make an appointment with a clinical dietitian nutritionist, call 212-639-7312.

Last Updated

Thursday, April 25, 2024

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