Soft and bite sized diet IDDSI Level 6

International Dysphagia Diet Standardisation Initiative

Soft and bite sized diet IDDSI Level 6 (142kB pdf)

What are soft and bite sized foods (IDDSI Level 6)?

Soft and bite sized foods

  • Can be eaten with a fork or a spoon
  • Do not require a knife to cut the food but may be helpful to load the fork or spoon. Pressure from the fork held on its side can be used to cut/break this texture
  • Can be mashed or broken down with a fork or spoon
  • Require chewing before swallowing
  • Are soft, tender and moist throughout, but with no separate thin liquids
  • Require pieces to be cut no bigger than 1.5cm x 1.5cm

What does this mean for me?

A speech and language therapist has recommended your diet to be modified to Soft and Bited Sized (IDDSI Level 6). By modifying food to this consistency, eating may become easier and safer for you, reducing the risk of aspiration (food/fluid entering the airway), which can occur when a person has dysphagia (swallowing difficulties).

Hints and tips

If you are unsure whether your food is the correct consistency for a Soft and Bited Sized diet, you can test it by using a fork:

When firm pressure is applied to food and released it
will squash and change shape (it will not return to its original shape).

How to prepare soft and bite sized food

Meat, Quorn and fish

  • Soft enough to break into small pieces with a fork or spoon
  • No bones
  • Fish with no batter

Casserole, stew and curry

  • Liquid portion must be thick or removed if you are on a thickened fluid consistency
  • Contents must be cut no bigger than 1.5 cm x 1.5 cm, be moist, tender and a soft consistency with no hard lumps

Fruit

  • Served mashed and excess juice drained
  • Fibrous parts of fruit are not suitable e.g. orange peel & skin
  • Fruit that has a high liquid content needs to be avoided, unless your therapist has assessed you with these


Vegetables, tofu and tempeh

  • Steam/boil vegetables etc until they are soft and easily cut with the side of a fork
  • Stir fried vegetables are often too firm and not soft or tender

Cereal

  • Smooth with soft tender lumps
  • Texture fully softened
  • Drain away any excess liquid

Bread, burritos, wraps

  • No regular, dry bread etc unless assessed as suitable by your therapist

Rice, couscous

  • Not particulate/grainy, sticky or glutinous

Ideas for a soft and bite sized diet (IDDSI Level 6)

The websites below may provide some ideas and general guidance for puree meals/recipes

Unsafe swallow (dysphagia)

Symptoms of dysphagia may include:

  • Coughing
  • Wet/gurgly voice
  • Pain on swallowing
  • Eyes watering while eating/drinking
  • Repeated chest infections
  • Drooling/dribbling
  • Difficulty breathing during or just after eating
  • Unintentional weight loss
  • Sticking sensation in throat or chest

Safe swallowing advice at meal times

  • Ensure you are fully alert
  • Sit upright while eating and drinking and for 30 minutes after
  • Do not eat while lying down, it is very unsafe to swallow in this position
  • Eat slowly, have small mouthfuls and take time
  • Try not to talk while eating or drinking
  • Check that there is no residue left in the mouth, either by using your tongue, using a mirror or asking someone
  • Minimise distractions by turning off the radio, TV etc.

If you have any concerns regarding your swallowing, please contact your GP for a referral to the local speech and language therapy team.

Further information

Wiltshire Farm Foods: www.wiltshirefarmfoods.com
Oak House Foods: www.oakhousefoods.co.uk
International Dysphagia Diet Standardisation Initiative: iddsi.org/framework/

If you would like to give feedback on your care, please contact our patient experience team on [email protected] or 01279 827211.