Supercol® for Swallowing Difficulties (Dysphagia)

Formula/thickener combinations using Supercol® were initially prepared using a standard metric 1/4 teaspoon (1.25 ml, Supercol® mean weight = 0.68 g) measurement. According to Supercol® Australia [27], 1/4 teaspoon of Supercol® thickener is equivalent to 2 scoops of Supercol® thickener using the provided scoop. This amount of thickener is recommended for formula volumes of 200 ml. Where possible, the study aimed to devise recipes using the smallest possible fluid volumes to the nearest 50 ml, without resorting to impractically small amounts of Supercol®. Final recipes are therefore representative of the smallest possible volume trialed (to the nearest 50 ml).

To facilitate mixing of formula/thickener samples, Supercol® was added gradually to the formula and whisked simultaneously as per the manufacturer instructions, using a hand whisk. The initial sample was whisked for 30 s. Samples were whisked again for 10 s prior to conducting each IDDSI Flow Test at each timepoint to maximize homogeneity of thickness. Where formula/thickener samples were too thick, the amount of Supercol® thickener added was reduced by 1/8 teaspoon (mean weight = 0.44 g) or the volume of the sample was systematically reduced by 50 ml until a consistent thickening pattern to Level 1 (slightly thick) was observed. Where samples were too thin, the amount of Supercol® thickener added was increased by 1/8 teaspoon or the volume of formula used was decreased by 50 ml.

At times, formulas mixed with Supercol® blocked the syringe, preventing fluid flow. Where this occurred, a new sample was immediately withdrawn with a clean syringe and the flow test was repeated.