Having a child diagnosed with aspiration or pharyngeal dysphagia can be overwhelming, daunting, and discouraging. With one set of answers comes another set of challenges and questions. If your child can’t have thin liquids, it’s obvious that you’ll need to avoid water and juice… but what else is considered a thin liquid? Some of these might surprise you!

1. Ice cream

Ice cream may seem thick in it’s frozen form, but it melts into a thin liquid almost immediately once in the mouth. Combine that with saliva? Now we really have a thin liquid! This can be problematic to our little ones with aspiration. To further complicate things, there is some evidence to suggest that aspiration of milk based products increases risk of adverse reactions such as respiratory infection or pneumonia when compared to water or water based products.

2. Milk, Nutrition Shakes, and Infant Formula

They may seem a lot thicker than water but they aren’t typically thick enough to take them beyond the viscosity range that is considered a thin liquid. As we see with ice cream, aspiration of milk and shakes can be far more traumatic to the lungs than aspiration of water.

3. Jello

Again, this is a snack that looks and feels thick, but quickly becomes a thin liquid within the mouth. If your child is on thickened liquid, try making box mix gelatin and adding thickener per the container instructions prior to setting it in the refrigerator.

4. Juicy Fruit and Fruit Cups

Juicy fruits such as certain berries, melons, citrus fruits, and grapes can release a surge of thin liquids as soon as a child bites into them. Compound this with the fact that these items are what we refer to as mixed consistencies, or foods containing both a liquid and solid component. Mixed consistencies are notoriously difficult to manage because the brain has to manage two different properties of food (each requiring different swallowing behaviors) simultaneously.

5. Broth-based soups

Both broth based and many tomato based soups behave as thin liquids. And remember that comment about mixed consistencies? Well, add some diced veggies or bits of chicken to the broth and here you have another dreaded mixed consistency. (But don’t worry- we have some tips below on how to keep soups in the rotation if they’re a family favorite!)

How can you know for sure??

When in doubt, test it out! A tutorial on fool-proof liquid viscosity testing using the syringe method. Be sure to pay special attention to the specific type of syringe required to complete testing. They aren’t expensive, but you do want to make sure that yours are the right height and diameter for accurate testing!

BUT MY CHILD LOVES TO EAT THESE THINGS!!! What can I do??

As with all other liquids your child consumes, you can always pre-thicken them to the desired viscosity.

• Try making home made ice cream using thickened milk or cream with your little ones!
• Pre-thicken jello before allowing it to set.
• Get creative! Don’t want to add commercial thickeners to the family stew? Corn starch, instant potato flakes, and other “real food” products can be added to soups to increase viscosity. You may find that the whole family enjoys it! You can also opt for thicker creamy soups, just be sure to viscosity test before giving it to your little ones to make sure its safe.