Thickened fluids are usually prescribed at varying levels to avoid aspiration, fluids going down the wrong way, that may be a result of poor oral control or impaired mechanisms in the throat that no longer adequately protect the airway, or a combination of both.
Often, the viscosity of the fluid dictates how quickly the fluid moves around the mouth and down the throat, with thicker consistencies moving more slowly and allowing more time to control it, often making it easier to manage. However, the more viscous or thick a fluid, the heavier it is which means a person has to have the oral and tongue strength to transfer and control it. When I use the term "heavier" in relation to fluids, it is not heavy like solid foods however the continuum that is mapped out by IDDSI levels demonstrates how the thickening of fluids transitions into solid forms that we consider food and vice versa.
Generally, rather than trying to find naturally occurring thickened fluids, thickening powder is used to modify the consistency. This is the case for drinks, sauces, soups and anything else of a smooth and runny consistency. Each brand of thickener will have its own "recipe" so to speak, in order to reach each level of modified fluids so this should always be followed when thickening fluids. The remaining IDDSI levels not yet discussed include Level 2- mildly thick fluids, Level 1- slightly thick fluids, and Level 0- regular fluids.
Mildly thick fluids can be sipped through a straw with mild effort, flows off a spoon and will have 4-8ml left in the syringe barrel after a 10 second flow test.
Slightly thick fluids are often used in the paediatric population as they are thin enough to flow through the teat of a bottle. It is also appropriate and used for adults as it can be sippped through a straw with little effort and sipped from a cup too. This flows a little slower than normal fluids as it is thicker than water and flows off a spoon easily. This consistency should have 1-4ml left over in the syringe barrel after a 10 second syringe test.
Thin fluids are what we know as normal fluids that are the same or similar consistency as water and flows rapidly. Generally if someone can tolerate thin fluids they should also be able to tolerate thicker fluids, unless otherwise indicated by your speech pathologist. There should be no fluid left in the barrel of a syringe after a 10 second flow test.
As mentioned, thickener is often used to make drinks to the appropriate IDDSI level and the same for sauces, soups and syrups. However, there are also a bunch of culinary tips and tricks that can thicken up these food and drink products without having to use thickener which will be more the focus here at The Fourth Place. Especially because this means you can prepare a sauce or soup, for example, to a range of consistencies dependent on the person's needs or recommendations. It's all in the creativity and the vision.
** These posts are not meant to be used as a diagnostic tool. Diet and fluid recommendations should be prescribed by a practicing speech pathologist. **
** ‘These are NOT official IDDSI resources, educational materials or education programs and they are NOT meant to replace materials and resources on www.IDDSI.org’ **
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