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Dietary suggestions for swallowing difficulties

Ngā marohitanga kai mō ngā taumahatanga horomi

If you have problems swallowing, your speech-language therapist may recommend that you change the consistency of your food and fluids (drinks). This is to help you eat and drink better and more safely.

IDDSI

IDDSI framework diagram showing an inverted triangle of food going from regular easy to chew food down to liquidised food and a triangle of drinks going from extremely thick down to thin.IDDSI stands for International Dysphagia Diet Standardisation Initiative. It is an international standard for food and fluids for people with swallowing difficulties.

The IDDSI framework has eight levels as shown in the diagram.

If you have swallowing difficulties, your speech-language therapist will assess you. They will work out what levels you need for food and fluids. When you know what levels to use, use the appropriate leaflets below.

Only use the leaflets after getting advice from your speech-language therapist. Do not change to a different level without first checking with a health professional.

This website is not the official IDDSI website. See the IDDSI website for the most up to date IDDSI information and resources.

Nutrition

If you are struggling to maintain a healthy weight, you may need to see a dietitian. A dietitian can help you make sure the food you are eating is well balanced and nutritious as well as having the right consistency.

What to do if you have problems

If you have problems like starting to cough after drinking, contact your speech-language therapist.

Testing

The food leaflets have information about testing. The testing is to make sure your food has the right consistency.

If someone else prepares your food, they will make sure the consistency is right. If you prepare your own food, you can use the tests. When you get used to preparing your food, you will probably not need to do the tests every time.

The fluids leaflets also have information about testing. If you prepare your own fluids, you will probably not need to do the testing yourself. You will usually follow instructions given to you by your speech-language therapist. Your speech-language therapist will tell you how much thickener to add to the fluids.

Some of the fluids tests measure how much liquid is left in a syringe after ten seconds of flow. If you want to find out about flow testing, see IDDSI flow test videos. This page has several videos in a YouTube playlist.

Leaflets

Fluids

Slightly thick fluids consumer handout

Slightly thick fluids (IDDSI level 1)

Mildly thick fluids consumer handout

Mildly thick fluids (IDDSI level 2)

Moderately thick fluids consumer handout

Moderately thick fluids (IDDSI level 3)

Food

Liquidised foods consumer handout

Liquidised food (IDDSI level 3)

Pureed food consumer handout

Pureed food (IDDSI level 4)

Minced and Moist Food Consumer Handout

Minced and moist food (IDDSI level 5)

Soft and bite-sized food consumer handout

Soft and bite-sized food (IDDSI level 6)

Regular easy to chew food consumer handout

Regular easy to chew food (IDDSI level 7)

Written by HealthInfo clinical advisers. Last reviewed July 2023.

Sources

See also:

Thickening fluids

© The International Dysphagia Diet Standardisation Initiative 2019 @ https://iddsi.org/framework. Licensed under the Creative Commons Attribution Sharealike 4.0 License https://creativecommons.org/licenses/by-sa/4.0/legalcode. Derivative works extending beyond language translation are NOT PERMITTED.

Page reference: 79704

Review key: HISWD-121957