Implementing IDDSI on Gelmix + Purathick Labels

What is IDDSI?

IDDSI is short for International Dysphagia Diet Standardisation Initiative, a collaborative, international effort to standardize the way we talk about modified food and drink textures. For decades, descriptors of modified diet textures varied drastically between regions, and sometimes from facility to facility in the same area. Without easily measurable industry standards, miscommunication and confusion about the dysphagia diet often led to real safety risks for patients. The development and adoption of IDDSI guidelines reduces the confusion with global descriptors and easy, reliable measuring techniques. In 2017, ASHA announced its support for the adoption of IDDSI in the United States, and throughout 2018, many started to prepare for full implementation and adoption of IDDSI at the institutional level.

Basic IDDSI Framework & Testing Method for Thickened Drinks

The IDDSI framework of terminology includes 4 levels of thickened liquids. It also includes an objective measurement of liquid thickness with a flow test, using a 10 ml syringe and a 10 second timer. 

How Parapharma Tech is Adopting IDDSI

Parapharma Tech is proud to sponsor IDDSI. We worked throughout 2018 to standardize the Gelmix and Purathick mixing instructions and usage guidelines to be used within the IDDSI framework. While our product formulas and ingredients remain unchanged, we launched brand new labels that hit the market at the end of 2018. We are continuing to work with institutions that use our products to make them aware of  IDDSI and prepare them for the adoption of the new dual-labels.

Gelmix + IDDSI

Gelmix mixing instruction labels previously included two “nectar” recipes, based on National Dysphagia Diet terminology that relied on wide viscosity ranges, measured in centipoise (cP). Infants are often recommended thickened liquids for reflux or swallowing problems, but previous terminology did not include the thinner variation that is most commonly recommended for infants. The new IDDSI guidelines now includes Slightly Thick (Level 1), most commonly recommended for infants, and Mildly Thick (Level 2), which is similar to what we’ve previously recognized as nectar-thick. It is not commonly recommend to thicken infant milk above Mildly Thick because it is difficult to pass Moderately Thick (Level 3) and Extremely Thick liquids (Level 4) through a nipple.

When measured with the IDDSI flow test, we found our original Gelmix infant thickener recipes to be a little on the thin side, especially when used for breast milk, elemental formulas and some ready to feed formulas that tend to be thinner than regular powder formulas. Gelmix instructions now include a range to accommodate for the variations in thickness between breast milk and various formulas. We have a number of printable handouts with tips for use available to help consumers depending on if they are thickening with breast milk or formula. This section of our website is being updated with new printable docs over the next few months, so be sure to check back as IDDSI launches nation-wide in May 2019.

You might also we notice we updated our logo and packaging to be a little more fun!


Purathick + IDDSI

Since Purathick may be used by both adults and children over one year old, the new IDDSI compliant label includes all 4 recommended levels of thickened drinks to include pediatric and adult feeding therapies. Our new label includes the newly standardized IDDSI levels & corresponding triangles/colors. Purathick printable documents with user tips will be available soon, so be sure to check back as IDDSI launches nation-wide in May 2019.


To learn more about IDDSI and download additional resources, visit