Baby Formula and Food Thickeners: What are the options?

Posted 6.17.10 | Christine Graham-Garo

baby being fed
To follow up on Mallory’s post on Dysphagia, GERD, and Silent Aspiration in children, I wanted to use this post to discuss the use of thickeners to help with the treatment of GERD/GER, dysphagia and aspiration. I'll also share some commercially available thickeners.

If your little one is showing signs of GERD/GER, dysphagia or aspiration, you should always see a doctor to determine exactly what condition needs to be treated. One thing to remember is that children with Eosinophilic Esophagitis (EoE) can also have symptoms of dysphagia and often have symptoms very similar to that of GERD.

EoE is caused by food allergies and can be managed effectively by eliminating the allergens in your child’s diet. Thickening their food or formula may not be needed once the allergens are removed if the reflux also comes under control. Be sure to check with your child's doctor and/or speech pathologist to see if a food thickener is appropriate for your little one before trying one.

Thickening Foods and Liquids

If your child does have GERD/GER, dysphagia or aspiration, the healthcare team may recommend altering the thickness of food and liquids to help make them easier to swallow. When fluids are too thin, some children have trouble using their tongues and the muscles that help to swallow correctly, causing liquid to get caught in the airway passage and then get into their lungs. Thickening the formula and other fluids can help the liquids stay together during swallowing, decreasing the risk of aspiration, which is when fluid or food getting into the lungs (where it should not be!).

For infants with reflux symptoms, adding dry rice cereal or oat cereal to their formula or expressed breast milk to thicken it may be suggested by some healthcare professionals. It's important to note that there is not consensus on this, and not all healthcare teams agree that this is an acceptable approach. If your team suggests this, you should ask them what amount of cereal they recommended you add to your little one's bottle to help with reflux. You can read more about adding thickeners to Neocate here.

There are also some commercial thickeners on the market that may be options, depending on your child's age. It is important to read labels and call the company that makes the thickener if your child has food allergies to ensure the thickener doesn't contain any of their allergens. A few options in the market, and the manufacturer recommendations on who can use the product, include:

  • GelMix (not for use with infants under 42 weeks gestational age or with infants under six pounds)
  • ThickenUp (only appropriate for use in individuals greater than 3 years old)
  • Thick-It (not appropriate for use with premature infants, consult your physician before using with any infant)
  • SimplyThick (NOT intended for use with children under 12 years with a history of NEC, with preterm infants, or term infants under 12 months)

We do not have any specific commercial thickeners that we recommend for Neocate products. Any should work, and if your healthcare team recommends that the Neocate you use should be thickened, ask them what they recommend.

We hope this helped! What other questions do you have about thickeners?

- Christine
Nutrition Specialist

Read Comments (12)

  • 2014-03-24 | Shaelyn Hibbard

    I just wanted to add that I have been using Gelmix and it great. It’s all natural and organic and safe to use for formula and breast milk.

  • 2014-03-24 | Christine Graham-Garo

    Hi Shaelyn,
    Thanks for the comment. I’m going to look into it myself! smile  Thanks again.

  • 2015-11-05 | Tiffany

    I used Thick-It 2 for my son from the time he was 5 months old until he was a year. It was okay, I hated having to wait 5 minutes for it to be thick enough (stiff honey) for him. After he turned one we started using Simply Thick. I like it a lot better because it is good to go right after you mix it in, and it does not continue to get thicker if it sits for a while.

  • 2015-11-06 | Nutrition Specialist

    Hi Tiffany,
      It’s great to hear about your experience with thickeners. It’s hard to underestimate the convenience of not having to wait 5 minutes to start a feeding. Thanks for sharing!

  • 2016-01-20 | Stacey Edwards

    It may be worthwhile to update this article with a caution about using Simply Thick with preterm infants up to 12 months of age as per the manufacturer’s recommendation.

  • 2016-01-21 | Nutrition Specialist

    Thanks Stacey, great suggestion! We’ve added the manufacturers’ recommendations for age ranges on all products.

  • 2016-04-02 | Briana

    I was just informed about the dangers of simply thick. I feel terrible I didn’t know this as my nephew with Downs Syndrome has been using this product from 2.5 years until present. He does not have a hx of NEC, but none the less I want him to awitch ASAP! How long has GelMix been out there? I want to know it’s safe before recommending.

  • 2016-04-04 | Nutrition Specialist

    Briana, make sure to check with your healthcare team before making a switch. Lots of thickeners are available, and most people who need one have multiple safe options! We’ve known about GelMix for years, but the manufacturers would be able to tell you exactly how long it’s been in the market.

  • 2016-11-16 | Molly

    I’m really scared right now. I had no idea simply thick was not for babies. I give it to my elderly patients on a daily basis. Never once did it come up that there was a warning against babies. Goes to show you should always look. My premature baby has been aspirating. She was born at 35 weeks 5 days. She is now 4 weeks 5 days and I gave her a little less than two pumps of simply thick early this morning with peppermint water to help ease her colic and help her not aspirate. I know it’s not much but after I happened to glance down and see the warning label I’ve been googling and crying trying to figure out if it’s extended use that is in relation to the NEC or if one serving can do it. I would just die if I lost my precious Sapphire.

  • 2016-11-17 | Nutrition Specialist

    Hi Molly,
      We’re not very familiar with Simply Thick, so the best thing to do if you’re worried would be to contact your little one’s healthcare team to see if they have any concerns or if they would recommend anything. Hang in there and best of luck,

  • 2017-11-29 | Ann M Anderson

    What non-commercial thickeners would you recommend?  Cornstarch?  Agar?  My grandson was born at 28 weeks, and is now 19 months actual, but is having swallowing problems.

  • 2017-11-30 | Nutrition Specialist

    Hi Ann,
        We can’t provide medical advice, so we’re not able to recommend any of the thickeners you mentioned. It would be best for you to ask a feeding specialist, or Speech Language Pathologist (SLP), for their advice. If your son hasn’t seen an SLP, you should ask his healthcare team for a referral to see one. An SLP who specializes in feeding and swallowing disorders should evaluate your grandson and make appropriate recommendations, which make or may not include a thickener. You can locate an SLP here:
        Best of luck to you!

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Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.