​What is food consistency modification?

Food consistency modification is a compensatory strategy to modify food or fluid when feeding a child with feeding and/or swallowing difficulties (dysphagia) to ensure swallowing is safe (i.e. reduce choking risk).

This information is intended for general information. Please consult your speech therapist for specific advice.

Food and drinks consistency are classified using the IDDSI (International Dysphagia Diet Standardisation Initiative) classification system.

Food and drink consistency

​Level ​Description
0 Thin
  • ​Flows like water

  • Can flow through a straw or teat/nipple

1 Slightly Thick
  • ​Is thicker than water

  • Can flow through a straw, teat/nipple

2 Mildly Thick
  • ​Is sippable

  • Pours quickly form a spoon but slower than 'Thin' drinks and 'Slightly Thick' drinks

  • Needs some effort to drink using a standard straw

3 Moderately Thick
  • ​Can be drunk from a cup or taken with a spoon

  • Needs some effort to drink through a wide diameter straw and cannot be sucked through an infant teat/nipple

  • Has a smooth texture with no lumps, fibers or seeds

4 Extremely Thick
  • ​Is usually eaten with a spoon

  • Cannot be drunk from a cup or sucked through a straw or infant teat/nipple

  • Does not require chewing

  • Has a smooth texture with no lumps

  • Holds shape on a spoon

  • Is not sticky

Flow tests are used to ensure that accurate modifications made to achieve desired thickness of fluid.

Types of food consistency

​LevelDescription​
3 Liquidised
  • ​Can be eaten with a spoon or drunk from a cup

  • Cannot be eaten with a fork because it drips through the fork prongs

  • Has a smooth texture with no lumps

4 Pureed
  • ​Is usually eaten with a spoon

  • Does not require chewing

  • Has a smooth texture with no lumps

  • Holds shape on a spoon

  • Falls off a spoon in a single spoonful when tilted

  • Is NOT sticky

  • Liquid must not separate from solids

5 Minced and Moist
  • ​Soft and moist, but not liquid leaking/dripping from food

  • Biting is not required

  • Minimal chewing is required

  • Has lumps of 2mm in size, can be mashed with tongue

  • Food can be mashed with just a little pressure from a fork

  • Should be able to scoop food onto a food with no liquid dripping and no crumbles falling off fork

​6 Soft and Bite-sized
  • ​Soft, tender and moist, but with no thin liquid leaking/dropping from the food

  • Does not require the ability to bite off a piece of food

  • However, ability to chew bite-sized pieces is required

  • Bite-sized pieces should be no larger than 8mm x 8mm

  • Food can be mashed/broken down with pressure from fork

  • A knife not required to cut this food

​7 Easy to Chew/Regular
  • ​Normal, everyday foods

  • Any method can be used to eat these foods (e.g. using fingers, a fork, a spoon, chopsticks etc)

  • Food consists of a range of sizes, appropriate for the child’s age and level of development

Ref: K21