Introduction

What is a thickened fluid?

A thick fluid or liquid is one which has more bulk to it than a thin liquid, e.g. tomato juice vs. water

Why are thickened fluids needed? 

  • If the muscles in your mouth or throat are weak, slow or uncoordinated, it may be difficult to swallow safely. 
  • Some people may cough or splutter when drinking and this may be a sign that the drink has gone down the ‘wrong way’ and into the airway. 
  • Some people don’t show any of these signs (‘silent aspiration’) but may find they are getting recurrent chest infections. 
  • Thicker fluids move more slowly, giving the muscles more time to work and reducing the risk of drinks going down the wrong way. 

Thickeners are prescribed by your Doctor, often following recommendation from a Speech and Language Therapist. It is also important to ensure that foods that contain liquids are thickened to the appropriate consistency, e.g. milk in cereal, sauces, gravy, etc. You can also use cornflour, instant potato granules (e.g. Smash) or fresh, smooth mashed potato to thicken soups, gravy or savoury foods that are too runny.  

How thickened fluids can cause problems 

  • Drinks made with thickener need to be carefully made and as advised by the manufacturer. 
  • Thickened drinks might make your poo hard or runny. 
  • Thickeners can change the taste as well as the texture of drinks - some people don’t like this change. 
  • There is still a risk that thickened fluids could go into your lungs and cause serious health problems. 
  • Thickened drinks might make you want to drink less, making you feel thirsty and putting you at risk of dehydration. 
  • The use of thickeners in fluids might stop certain medications working properly. 

Remember – you or the person you care for has a choice in the use of thickened fluids and you can change your mind at any time. Talk to your healthcare professional about what is best for you.

Instructions for thickening drinks

Thickener should be put in the glass or cup before adding hot or cold drinks.

1.    Thickener should be put in the glass or cup before adding hot or cold drinks.

       Use blue scoop provided in each tub to measure the quantity of thickener.

       Use level scoops (NOT heaped).

2.    Then pour liquid over the powder quickly whilst stirring.
3.    Stir with a spoon or small whisk as you add the drink. 
       Keep stirring until all the powder has dissolved.

4.    It takes about 1-2 minutes for the drink to thicken. 

How much thickener do I need?

Drinks will need to be thickened to the following consistency:

Level 1 = 1 scoop per 200 ml
Level 2 = 2 scoops per 200 ml
Level 3 = 4 scoops per 200 ml
Level 4 = 6 scoops per 200ml

Remember to stir as you add the drink to the thickener, to avoid lumps forming.

For fizzy drinks, stir them before adding powder, to reduce the amount of gas in the drink. Then add the drink to the thickener as usual. They often bubble up when the powder is added, so it is best to thicken 200mls of fizzy drink in a larger jug.

What if more powder is needed?

You should be discharged from hospital with enough thickener to last a week.

On discharge, please request a prescription from the GP if this has not already been done. 

Note: The GP might not prescribe the same thickener that we use in the hospital (Resource ThickenUp Clear).

Other products are available. They work in the same way but are prepared differently, so please read the instructions carefully.
 

Note: Foods such as ice-cream and Jelly are not appropriate if you are on thickened fluids, as these melt to a thinner liquid consistency in the mouth and increase the risk of them going down the ‘wrong way’. 

Texture

Description of Fluid Texture

Fluid Examples

Thin ‘normal’ Fluids

Still water/normal drinks

Water, Tea, Coffee, Squash, Alcohol

Level 1

‘Slightly thick’

The product should leave a coating on the side of a glass

Smoothies, milkshakes or yoghurt drinks (but may require some thickener)

Level 2

‘Mildly thick’

Can be drunk through a straw

Can be drunk from a cup

Leaves a thin coating on the back of a spoon

Tomato juice

Yoghurt drinks

Olive oil

Double cream

Level 3

‘Moderately thick’

Cannot be drunk through a straw

Can be drunk from a cup

Leaves a thick coating on the back of a spoon

Honey

Thick cream soup

Level 4

‘Extremely thick’

Spoon will stand up in drink

Cannot be drunk through a straw

Cannot be drunk from a cup

Needs to be taken with a spoon

Mousse

Thick custard

Contact us

If you have any queries relating to this information, please contact the Speech and language therapy service.

About this information

Service:
Speech and language therapy

Reference:
VV/006

Approval date:
20 September 2024

Review date:
1 September 2027

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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.