Advice after your nerve block for surgery
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Introduction
If you are having difficulty chewing or swallowing, puréed foods may be easier to manage. These are foods which have been liquidised to a thick, smooth, uniform consistency. They should be moist and cohesive enough to hold their shape on a spoon e.g. yoghurt.
This leaflet can help you choose suitable foods, adapt your own dishes and give you advice on how to get the most nutrition from your meals.
Equipment
You will need one of the following:
- A liquidiser
- A food processor
- A hand-held blender which is ideal for small quantities and is a less expensive option
How to Purée Your Food
- Most food can be puréed
- Solid foods should be well-cooked, chopped into small pieces and blended
- Extra liquid will probably need to be added to gain the correct consistency and to ensure the meal is not too dry
- Ensure a smooth purée by liquidising small quantities at a time. You may need a sieve to remove any pips, lumps or skins (for example from beans) that are still left
Thickened Fluids
If you are on thickened fluids some of the items in this booklet may not be safe for you, for example soups, smoothies, ice cream and custard. In some cases, these items can be thickened to make them safe using a thickening agent, e.g. Resource Thicken Up or Thick and Easy.
If you have difficulty swallowing fluids, your speech and language therapist should give you advice on whether or not you need to thicken your fluids.
Maximising Nutrition to Help Maintain Weight
Puréed meals can be bulky, making you feel full quickly. It is important to make meals as nourishing as possible, particularly if your appetite is small. It is often easier to improve your nutritional intake by adopting a small, frequent meal pattern (see page 11 for details).
Here are some suggestions to maximise nutrition:
- Use high energy liquids when extra fluid is required to give the correct consistency. Water does not contain any calories so it is preferable to use full fat milk, evaporated milk, cream, creamysauces, rich gravy, custard or juice as these will add extra calories to the meal.
- Add high energy foods where possible, such as butter, margarine, milk powder, grated cheese, sugar, seedless jam or honey.
- Use full fat foods (not diet variety) - ordinary fromage frais, thick and creamy yoghurts, full fat margarines and butter, full cream milk.
- Try to avoid skimmed or semi-skimmed milk, any product labelled fat free/low fat/light (lite), reduced sugar, sugar free, low calorie or slimming endorsed foods
- Fortified milk is made by adding four tablespoons of milk powder to one pint of full cream milk. This will add extra nourishment without increasing the amount of milk you need to drink.
- It can be used to make mashed potato, porridge, packet or condensed soups and even milk puddings. This can be used whenever you would normally use milk
- Add plenty of sugar to your food (unless you have diabetes, where a sweetener or low sugar alternative can be used). Always drink ordinary squash rather than the diet variety
- Fortified drinks such as Complan, Meritene and Polycal can be purchased from the chemist or supermarket. They are useful in between your meals, particularly if you are not managing to eat a great deal.
Making Food Look Appetizing
Attractive looking food can stimulate a poor appetite and help you get the nourishment you need. Puréed food lacks texture and can tend to look bland and uninteresting, but there are various ways of improving this.
Separate Different Foods
Always purée foods separately (vegetables separate from meat/fish and pulses) so that it keeps its own colour and flavour. Arrange different foods individually on the plate and consider using a smaller plate for a small meal. A plate with dividers can be useful to prevent food from collapsing and running into each other.
Colour
Think of the colours of the various items of food when you plan your meal. Combine a bright coloured vegetable with a paler food e.g. carrots or broccoli with creamed potato and chicken in a creamy sauce.
Flavour
To stimulate the appetite, try to vary the flavours in the meal. Use spices, herbs and a variety of sauces e.g. soy, Worcester, tomato, barbecue, curry, lemon juice, balsamic vinegar, paprika, black pepper or mint jelly.
Desserts
Serve desserts in individual glasses, pipe some cream on top and dust with icing sugar, cocoa or drinking chocolate. Seedless jam, lemon curd or other colourful sauces can be added to milk puddings.
Temperature
Once you have blended hot food, heat it up to its usual temperature in a pan or microwave, as blending will make it cooler.
Blending also warms up cold foods so ensure you chill the food in the fridge prior to eating.
Time Saving Ideas Using Convenience Foods
N.B. You may be tempted to try commercial baby foods, but these are expensive and do not provide adequate nourishment for adults, such as vitamins, minerals and protein.
However, if you are unable to prepare food at home, Witshire Farm Foods, Oakhouse Foods and Parsley Box offer texture-modified ‘ready’ meals.
Cooking and processing puréed food can be time consuming, especially as
you will tend to eat more often. Not everything needs to be prepared from
scratch - many different convenience foods can be used.
Here are some appropriate meal ideas:
Breakfast Cereals
Instant oat cereals i.e. Ready Brek, Weetabix - add sufficient milk to achieve required consistency. These can be eaten at any time and served topped with cream, sugar or golden syrup.
Ready-to-Eat Meals
Tinned, packet, frozen or boil-in-the-bag foods can be reheated according to the instructions on the packet and then liquidised. If necessary, thicken with some mashed potato or serve with an extra jug of sauce or gravy. Casseroles, fisherman’s pie, roast dinners and curries can all be prepared this way.
Potatoes and Vegetables
Instant mash potato is useful not only as mashed potato, but also in powder form as a thickener for other puréed dishes. Adding grated cheese and/or butter or milk can improve the flavour and texture of mashed potato. Tinned vegetables can also be puréed, however if they have skins (beans, peas)
remember to sieve them.
Sauces/Gravy Mixes
Granules, tinned, and packet mixes can all be used.
Tinned and Packet Soups
These are not always very nutritious so make up the soup with full cream milk rather than water. Try adding extra foods or liquids to enrich the soup such as puréed lentils, beans or barley, cream and milk powder.
Desserts
There are many suitable instant puddings on the market e.g. Angel Delight, ready- prepared single serving pots of mousse, thick or set yoghurt (avoid those with fruit pieces) and fromage frais. Remember to avoid diet or low-fat options.
Tinned rice pudding can be puréed and given extra flavour with seedless jam. Sweet sauces such as chocolate, strawberry and maple syrup can be used to add variety to basic desserts such as ice -cream, milk puddings and mousses.
A lightly mashed banana with some cream, custard or runny honey makes a very quick instant dessert or snack.
Sponge cake can be soaked with fruit juice and served with evaporated milk or cream to provide a nourishing pudding.
Other possible desserts include stewed and puréed apple served with custard, cream or ice cream, puréed rice pudding or full fat Greek yoghurt.
Portioning and Freezing Food
If you have a freezer, you may find it convenient to make up a full recipe of some dishes (4-6 servings) and then divide into portions to be frozen. Clean, empty yoghurt pots or margarine tubs are ideal for this; cool the food quickly after cooking and freeze immediately. Do not forget to label and date the pots.
Defrost the portions thoroughly at room temperature or in the microwave, then reheat. Food should not be reheated more than once because of the risk of food poisoning and defrosted food should never be re-frozen.
Constipation
Constipation can be a problem for people following a puréed diet, this may be because:
- You are not including foods that are high in fibre; liquidising does not destroy the fibre in foods. Use wholegrain cereals such as Weetabix, have digestives “dunked” in your favourite drink and include all types of vegetables and fruit, particularly prunes
- Your fluid intake is insufficient, so aim for 6-8 cups of fluid a day. If drinking is very difficult, ask to be referred to a speech and language therapist
If you are increasing your fibre intake, it is best to do so gradually over the course of a few weeks.
N.B. It is even more important to drink sufficient fluid if you are following a high fibre diet.
Examples of Puréed Options
Meat, Poultry and Fish - these will need to be puréed with some type of sauce or gravy
- Chicken and gravy
- Chicken and white sauce/wine sauce or mushroom sauce
- Well- casseroled pork/beef in gravy
- Well- casseroled pork/beef in bolognaise sauce
- Ham in parsley sauce
- Flaked, steamed/poached or tinned fish (beware of bones) in white, cheese or parsley sauce
- Take care with cod as this can be very dry and fibrous when puréed
Eggs
- Softly scrambled egg - try adding grated cheese to change the flavour. Add butter and milk or cream
Potatoes
- Mashed, well-cooked potatoes, add plenty of butter and milk/cream
- Try adding cheese or cheese with puréed baked beans
Cereals - made with full fat milk
- Ready Brek or supermarket own brand instant oats
- Weetabix with plenty of milk
- Add sugar, honey, jam or cream
Vegetables - well-cooked and puréed with stock and butter
(remove skins and pips)
- Tinned, frozen and fresh vegetables are all good
- Add butter, cream and/or cheese
- Well puréed pulses
- Avoid fibrous vegetables such as celery, cabbage and mushrooms
Fruit
- Remove skins and pips
- Cook apples, pears or plums before you purée
- Tinned fruit, other than pineapple, purée well
Serve with cream, custard or ice cream.
Puddings - avoid diet or low fat
- Ice cream
- Mousses
- Soufflés
- Blancmanges
- Creamy yoghurts
- Sorbet
- Angel Delight dessert made with full fat milk
- Crème caramel
- Puréed milk puddings
- Jelly - try adding puréed fruit
A Sample Menu
Breakfast
- Sweetened fruit juice
- Porridge made with fortified milk and add sugar or honey
- Yoghurt - thick and creamy or set (no bits)
Mid-morning
- Milky coffee with “dunked” biscuit
Lunch (light meal)
- Thick, smooth, fortified soup
- Sieved baked beans with mashed potato
Mid-afternoon
- Fortified drink/high calorie milk shake
- Mashed banana with sugar or fruit fool or chocolate mousse
Evening Meal
- Puréed pork and apple casserole
- Puréed carrots
- Creamed potato with added butter
- Milk pudding made with fortified milk, served with seedless jam
Bedtime
- Milky drink - malted/chocolate/coffee
- Weetabix made with hot or cold milk (use fortified milk)
Some Simple Recipes
Soups
Fortified High Protein Soup
- ⅓ pint cream soup, e.g. cream of tomato
- 1 dessertspoon skimmed milk powder or 1 tablespoon Complan/Polycal
- A dash of cream
Stir the milk powder or Complan/Polycal into cold soup and heat. Add a swirl
of cream just before serving.
Meat and Vegetable Soup
- 1-2oz cooked meat
- 2oz cooked vegetables
- 4 tablespoons gravy
- ½ cup of stock
- Liquidise well.
Puddings
Milk Pudding
- 4 tablespoons milk pudding or custard
- 4 tablespoons hot milk
- 1 tablespoon skimmed milk powder or Complan
• A dash of cream and seedless jam (optional)
Liquidise together or push through a sieve.
Yoghurt Cup
- 1 tub fruit yoghurt, sieved
- ¼ pint milk or yoghurt drink, e.g. Yop, Actimel
- A dash of cream or evaporated milk
- 1 dessertspoon sugar or glucose
- Stir well and chill.
High Calorie Fruit Fool
- 4oz soft fruit, e.g. tinned peaches, pears, banana etc.
- 4 tablespoons cream or evaporated milk
- 1 dessertspoon sugar or glucose
- Liquidise together or push through a sieve. Serve either hot or cold.
Luxury Chocolate Cup
- 1 cup of hot milk
- 1oz plain chocolate, dissolved in a little hot milk
- Sugar or glucose (optional)
- A swirl of cream
- Mix together.
Eating Out
If you are eating out, let the restaurant know beforehand that you need a special diet and what your requirements are; most places will be happy to cater for you.
If you know you need longer to eat than others, think about ordering a main course and ask for that while everyone else is eating his or her starter. You may then be ready for dessert at the same time as everyone else.
Contact us
If you have any queries relating to this information, please contact the Dietetics service.
About this information
Service:
Dietetics
Reference:
DT/056
Approval date:
1 March 2026
Review date:
1 March 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.