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Dysphagia safety – thickened fluids for children fact sheet

Dysphagia safety – thickened fluids for children

Thickened fluids for children

Thickened fluids are safe for most babies and children, however only certain products should be used depending on your child’s age (see thickening product information fact sheet). Thickened fluids are not recommended for:

  • babies born prematurely who are not yet term age (e.g. baby born at 26 weeks who is now 35 weeks)
  • children with a history of necrotizing enterocolitis (NEC).

Consultation with your child’s speech pathologist, dietitian and/or medical team is recommended if your child is on a ketogenic diet, has an allergy to thickener ingredients, has monosaccharide intolerance or problems that affect carbohydrate absorption/digestion.

What liquids do I need to thicken?

You must thicken every drink that your child has, this includes (but is not limited to):

  • expressed breast milk
  • water
  • milk
  • formula
  • juice (including juice boxes)
  • soft drink.

See the ‘Food and fluids to avoid for children on thickened fluids’ fact sheet for more information about foods/drinks your child must avoid.

Do I need to modify my child’s drinking utensils?

You might need to change or modify your child’s feeding equipment to make sure they can drink safely. Your speech pathologist can help you find appropriate teats or cups.

Levels of fluid thickness

There are four different levels of thickened fluids. Your speech pathologist will tell you which level is right for your child. Fluids that have not been thickened are called ‘regular’ or ‘thin’ fluids.

Levels of fluid thickness
It is important to make sure the fluids you give your child are the correct thickness level. If you prepare fluids that are too thin, your child is at risk of aspiration (where fluid goes into the lungs). If you prepare fluids that are too thick for your child, they may not be able to drink enough to stay hydrated.

How do I prepare my child’s thickened drinks?

To prepare your child’s drinks, you will need your child’s drink and thickening product. Depending on your child’s thickener, you may also need something to mix the thickener in with (e.g. fork, spoon or whisk).

  1. Measure out the correct amount of fluid as per the thickener instructions (e.g. 100ml, 190ml)
  2. Measure out the correct amount of thickening product as per the thickener instructions (e.g. 1 scoop)
  3. Mix together as per thickener instructions (e.g. shake, stir, blend)

Most thickening agents used with children over the age of one are stable and can be kept for 24 hours. This means that you can prepare a large volume of fluids in the morning, and then send to day-care or school with your child, or keep them in the fridge at home.

Contact us

Speech Pathology Department (7a)
Level 7, Queensland Children’s Hospital
501 Stanley Street
South Brisbane 4101
t: 07 3068 2375
e: LCCH-Speech@health.qld.gov.au

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

References

  1. American Speech-Language-Hearing Association (2017). Pediatric Dysphagia. Retrieved from: http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&section=Treatment
  2. Dietitians Association of Australia and the Speech Pathology Association of Australia Limited. (2007). Australian standardised definitions and terminology for texture-modified foods and fluids, Nutrition & Dietetics, 64 (Suppl. 2), S53–S76.
  3. Gosa M, Dodrill P: Effects of time and temperature on thickened fluids. In Proceedings of the American Speech Hearing Association Conference, New Orleans, November 2009.
  4. Groher, M., & Crary, M. (2015). Dysphagia: Clinical Management in Adults and Children. Saint Louis: Elsevier Health Sciences.
  5. CreativeCommons Attribution. (2017). Complete IDDSI Framework detailed definitions. Retrieved from http://iddsi.org/Documents/IDDSIFramework-CompleteFramework.pdf

Resource No: FS321. Developed by the Speech Pathology Department, Queensland Children’s Hospital. Updated: July 2018. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

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