Modified texture diets

Modified texture diets

Eating and drinking are activities that many people take for granted, however they are very complex processes that involve the use and coordination of many muscles. If your child has difficulty eating, a referral should be made for a feeding assessment (NHS Choices, 2018). Usually a speech and language therapist trained in the area of feeding and swallowing will conduct the assessment.

Food

Individuals may need to eat a texture modified diet because they are generally unwell, through personal choice or because they have dysphagia (Dining with Dignity, 2018). Some children with eating difficulties need a modified consistency diet to assist with chewing and/or swallowing. Changing the food's texture causes different responses in children and can make a difference in your child's ability to manage food in their mouth. When changing food texture, therapists typically begin with a texture that is easiest for the child to manage. Foods are broken down into four categories:

  • Thin Puree
  • Thick Puree
  • Pre-mashed
  • Fork mashable (National Institute for Health Research,2014)

Food textures can be modified by preparing the food more, adding more fluid, cooking for longer, straining and using thickening agents. When altering consistencies of food, individual foods should be kept separate for both flavour and appearance. Note that mixed consistency foods (e.g. soup with vegetables) can be challenging, because your child must be able to handle the liquid and the solid.

Fluid

Liquids also vary in consistency including:

  • Thin/regular such as water and juice
  • Naturally thick such as fruit nectar
  • Mildly thick such as thin custard or yoghurt
  • Moderately thick such as mashed potato, thick gravies and jelly.

Thin liquids are often the most difficult to swallow because they move very quickly and so require very good oral control to keep them in the mouth and to control how they move back to be swallowed. Thicker liquids have more mass, shape and tend to move more slowly - this can compensate for weakened oral skills and sluggish swallow movements. However, they may not be as thirst quenching and are often more filling than thin fluids.

Further reading

Useful information on Dysphagia (swallowing difficulties) can be found on the NHS Choices website. Useful information on modified texture diets can be found on the NIHR website.

It is important to only make changes to your child's food under the supervision of a qualified professional who has completed their assessment of need. For more advice about a referral, you can speak to your GP, nurse or health visitor.
Advice last checked: 26 February 2018 Next check due: 26 February 2021

All advice is either supported by references (cited in the text) or is based upon peer reviewed professional opinion. Our advice is impartial and not influenced by sponsors or product suppliers listed on the site.
Conflict of interest statement

References

  1. Can Child 2003  Feeding and Eating Interventions for Children and Youth with Brain Injury
    View reference   Last visited:  21/09/2015
  2. Novita Children's Services 2008  Introduction to Food & Fluid Consistencies
    View reference   Last visited:  13/03/2009 Evidence type: 2
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