What are IDDSI Level 2 Mildly Thick Fluids?
IDDSI, the International Dysphagia Diet Standardisation Initiative, provides a global framework for classifying food textures and drink thicknesses for individuals with dysphagia. Level 2, designated as 'Mildly Thick,' is a specific consistency that flows more slowly than water but remains sippable. This slowed flow rate allows individuals with swallowing difficulties better control over the liquid, reducing the risk of aspiration, where fluid enters the lungs.
To be classified as Level 2, a liquid must meet the criteria of the IDDSI Flow Test, where 4-8mL of fluid remains in a 10mL syringe after 10 seconds. This consistency is often described as resembling a thick cream soup or a thin syrup.
Brand-Specific Scoop Requirements for Level 2 Fluids
The most important takeaway is that there is no universal number of scoops for Level 2 fluids. Dosages are not interchangeable between brands because of different thickener compositions (e.g., gum-based versus starch-based) and varying scoop sizes. Always use the scoop provided in the thickener tin, as it is calibrated specifically for that product.
Comparison Table of Common Thickeners for Level 2 Fluids
| Thickener Brand | Dosage for 200ml Liquid | Notes |
|---|---|---|
| Resource ThickenUp Clear | 2 level scoops | Xanthan gum-based, allows standing time for thickening. |
| Nutilis Clear | 2 level scoops | Another common gum-based thickener brand. |
| Thick & Easy Clear | 2 level scoops | Specific dosage may vary slightly, always check the label. |
| Supercol | 3 level scoops | Based on a ratio of 1.5 scoops per 100ml. |
| SimplyThick® | 1 packet or 2 pumps per 4 oz | Pre-portioned gel, does not require scoops but illustrates brand variation. |
Step-by-Step Preparation for Mildly Thick Fluids
Following a consistent method is crucial for achieving the correct texture and preventing lumps. Here is a standard procedure, which should always be adapted based on the manufacturer's instructions on your specific product.
- Prepare the container. Ensure the cup or beaker is clean and dry before starting. Some gum-based thickeners require the powder to be added to a dry cup first.
- Measure the thickener. Use the scoop provided in the tin and measure the exact number of level scoops indicated on the product packaging for your desired liquid volume. For example, use two level scoops for 200ml if using Resource ThickenUp Clear.
- Add the liquid. Pour the liquid into the container. For hot drinks, mix the thickener first, and for fizzy drinks, stir out the fizz before thickening.
- Stir thoroughly. Stir briskly with a fork or whisk for approximately 30 seconds to ensure the powder is fully dissolved and lumps are avoided.
- Allow to stand. Leave the mixture to stand for the recommended time, usually 1 to 5 minutes, to reach its full thickness. Milky drinks may require more standing time.
- Verify consistency. Check the fluid with a spoon or perform the IDDSI Flow Test to ensure it has reached the mildly thick, Level 2 consistency.
Why Consistency is Critical
The importance of achieving the correct consistency cannot be overstated. A fluid that is too thin poses a significant aspiration risk for individuals with dysphagia, while a fluid that is too thick can increase the risk of residue forming in the pharynx, leading to other swallowing complications. The texture and flavour of thickened fluids can also influence overall fluid intake, so ensuring the correct thickness is key to maintaining proper hydration and nutrition.
Additional Tips for Successful Thickening
- Read the label: Always defer to the manufacturer's directions, even if you are familiar with other brands.
- Test before serving: A quick check ensures the fluid is safe. A Level 2 fluid will pour quickly off a spoon but is slower than an unthickened drink.
- Prepare as needed: Some thickeners continue to thicken over time. It is best practice to prepare thickened liquids just before consumption and not store them for long periods.
- Keep it cold: Cold drinks are often more palatable when thickened. Thickeners react faster in cold liquid.
Conclusion
When preparing beverages for individuals requiring dysphagia management, the question of how many scoops for level 2 fluids is always best answered by the specific product's instructions. While many common thickeners require two scoops per 200ml, this is not a universal rule. By carefully following the manufacturer's guidelines, using the provided scoop, and confirming the final consistency, caregivers can safely prepare Level 2 mildly thick fluids, helping to protect against aspiration and improve overall quality of life.
For more information on IDDSI standards and testing methods, visit the official IDDSI website.
