Quick answer: Nectar thick, honey thick and pudding thick are the older US names for three thickness levels. Today most care teams use the IDDSI scale instead: nectar is about IDDSI Level 2 (Mildly Thick), honey is about Level 3 (Moderately Thick), and pudding is about Level 4 (Extremely Thick). You can reach these levels two ways. Mix a powder like Thick-It or ThickenUp Clear into the drinks you already have, or buy drinks that come pre-thickened, like Thick-It Clear Advantage thickened water.
The right thickness is prescribed by a speech-language pathologist or doctor. Use the level they gave you, and don't change it on your own.
If you've just been handed a new thickness level, it's a lot to take in. This guide sorts out the names, shows how to check a drink at home, and compares the products so you can pick what fits your day.
Thickness levels at a glance
IDDSI stands for the International Dysphagia Diet Standardisation Initiative. Its scale replaced the old "nectar" and "honey" labels in many hospitals because those words meant different things to different brands. IDDSI notes that the old names are only a rough match, so go by the level number your care team wrote down.
| IDDSI level | Older name | What it's like | Quick check (IDDSI Flow Test) |
|---|---|---|---|
| 0: Thin | Thin | Water, coffee, juice | Less than 1 mL left in the syringe after 10 seconds |
| 1: Slightly Thick | No older match | A little thicker than water. Still flows through a straw | 1 to 4 mL left |
| 2: Mildly Thick | Nectar thick | Pours quickly from a spoon, like the syrup in canned fruit | 4 to 8 mL left |
| 3: Moderately Thick | Honey thick | Pours slowly and drips off a spoon. Can be sipped from a cup | More than 8 mL left, but some still flows |
| 4: Extremely Thick | Pudding thick | Usually eaten with a spoon. Holds its shape | Doesn't flow. Use the fork and spoon tests below |
How the Flow Test works: Take a 10 mL slip-tip syringe and pull out the plunger. Cover the tip with your finger, fill it to the 10 mL line, then let go and count 10 seconds. Cover the tip again and see how much is left.
For Level 4: Put some on a fork. It should sit in a mound and not drip through the prongs in a steady stream. On a spoon, it should hold its shape and slide off fairly easily when you tip the spoon.
Source: IDDSI testing methods and the IDDSI drinks poster.
IDDSI also has levels for thick foods, from Level 3 (Liquidised) up to Level 7 (Regular). Level 3 and Level 4 are shared by drinks and foods, which is why a pudding-thick drink and a smooth puree count as the same level.
Powder vs pre-thickened drinks
| Powder or gel thickener | Pre-thickened drinks | |
|---|---|---|
| How it works | You mix it into any drink, using the chart on the label | Open the bottle and pour. It's already at one set level |
| Drink choice | Almost anything: water, coffee, milk, juice, shakes | Only what's sold: mostly water and a few juices |
| Getting it right | Depends on measuring, stirring and waiting | Same thickness every bottle |
| Cost per serving | Usually lower | Usually higher |
| Best for | Home, daily use, variety | Travel, outings, busy mornings, backup supply |
Many caregivers use both. They mix powder at home and keep a few bottles on hand for appointments, overnight, or days when someone else is helping.
Gum vs starch thickeners: why it matters
Thickeners come in two main types, and they act differently.
Starch (cornstarch) thickeners, like Thick-It Original, are the classic powder. Thick-It lists its ingredients as modified cornstarch and maltodextrin. They're often the lower-cost choice. The catch is that starch keeps thickening as it sits, so a drink can get thicker than intended. Thick-It suggests drinking it within 30 minutes of mixing.
Gum (xanthan gum) thickeners, like Thick-It Clear Advantage and ThickenUp Clear, keep drinks clear instead of cloudy. Their makers say they hold a steady thickness after mixing. Caregivers often say the taste is closer to the plain drink. They usually cost more.
If a drink keeps turning out lumpy, too thick, or tastes "off," the type of thickener may be the reason. Ask your speech-language pathologist before switching, since the scoop amounts aren't the same from brand to brand.
Thick-It Clear Advantage thickened water
This is pre-thickened water. Thick-It makes it from artesian mineral water and xanthan gum, and lists it as sugar free, calorie free and flavorless. It comes in Mildly Thick (nectar) and Moderately Thick (honey).
A few useful facts from Thick-It:
- It doesn't keep thickening in the bottle.
- You can serve it cold or warm, and stir in drink mix, cocoa, or a powdered supplement.
- Unopened, it lasts about 18 months. Once opened, Thick-It lists up to 14 days in the fridge. Check the label on your bottle, since times can vary by product.
We carry the nectar (Level 2) version in two sizes:
- Thick-It Clear Advantage Nectar Consistency Thickened Water, 8 oz bottles, by the case of 24. Single bottles are handy for a purse or a bedside table.
- Thick-It Clear Advantage Thickened Water, Level 2 Mildly Thick, larger bottle, sold one at a time or in a case of 4, for pouring glasses at home.
Good fit when: the plan is Level 2 and you want water that's ready to go.
Thick-It Clear Advantage powder and Thick-It Original
People searching "Thick-It Clear Advantage" are often looking for the powder. It's xanthan gum, maltodextrin and ascorbic acid, so it's the gum type. Thick-It Original is the starch type. Both are mixed by following the chart on the can for your level. Thick-It notes that neither is meant for children under 2, and children under 12 should use them only with a doctor's guidance.
Nestle ThickenUp Clear
ThickenUp Clear is a gum-based powder from Nestle Health Science. Nestle lists the ingredients as maltodextrin, xanthan gum and potassium chloride. One canister can make any level from Slightly Thick to Extremely Thick. You just change the number of scoops.
Caregiver tip
Same level, different feel. A thickener that works in water may act differently in a shake or orange juice, so do a quick check each time you try a new drink.
What caregivers like is that it stays clear in water, juice and coffee. Follow the scoop chart on your canister, stir well, and give it a short wait to reach full thickness before serving.
We carry ThickenUp Clear in canisters, sold by the case of 12.
Good fit when: you want one product for many drinks, or the level may be adjusted by the care team over time.
Gelatein Plus
Gelatein Plus isn't a drink thickener. It's a ready-to-eat, high-protein gelatin from Medtrition. Each 4 oz serving has 160 calories and 20 grams of protein, and Medtrition lists it as IDDSI Level 4. It's also lactose free and gluten free, but it does contain milk protein.
It comes in Cherry, Lemon and Pineapple. One of our customers said it "fills the void" on busy days. If drinks feel like a chore, it can be a nice change of pace.
Shop Gelatein Plus High-Protein Gelatin.
Tips from caregivers
We read through Reddit threads in r/dysphagia, r/CaregiverSupport and r/slp, plus retailer reviews. Here's what came up most.
- Lumps are the top complaint. Stir the powder into the liquid while it's moving, or use a shaker bottle. Don't dump powder on top and hope.
- Mix a batch. Several caregivers mix a pitcher in the morning and keep it in the fridge, so a drink is always ready. Check your label for how long mixed drinks keep.
- Taste matters for fluids. If the person doesn't like it, they won't drink much. Trying different drinks, like juice, milk or decaf coffee, often helps. One caregiver found a gum thickener tasted better than cornstarch (r/dysphagia).
- Same level, different feel. A thickener that works in water may act differently in a shake or orange juice. Do a quick check each time you try a new drink.
- Keep bottles for outings. Powder at home, pre-thickened bottles for the car, appointments, or a hospital stay. Pre-thickened costs more, so many families save it for times when mixing is hard (r/CaregiverSupport).
- Fizzy drinks foam up. Let soda go a bit flat first, then stir gently.
- Ask what's allowed. Some foods melt into a thin liquid in the mouth, like ice cream or ice chips. Ask your care team before offering them.
Frequently asked questions
What's the difference between nectar thick and honey thick? Nectar thick (IDDSI Level 2, Mildly Thick) pours fairly quickly, a bit like canned-fruit syrup. Honey thick (IDDSI Level 3, Moderately Thick) is noticeably thicker and drips slowly off a spoon. Use only the level you were given.
What IDDSI level is nectar thick? Nectar thick is closest to IDDSI Level 2, Mildly Thick. Honey thick is closest to Level 3, and pudding thick is closest to Level 4.
Is Thick-It Clear Advantage the same as Thick-It Original? No. Clear Advantage is made with xanthan gum and stays clear. Original is made with modified cornstarch, and it keeps thickening as it sits.
What is Thick-It water? It's the common name for Thick-It Clear Advantage thickened water: water that comes already thickened to nectar or honey consistency, so there's nothing to mix.
How long does thickened water last after opening? Thick-It lists up to 14 days in the fridge once opened, and about 18 months unopened. Always check the label on your bottle.
Can I make thickened water at home? Yes. Mix a thickener like ThickenUp Clear into plain water using the chart on the canister for your level, then do the Flow Test if you're unsure.
Get what you need delivered
Browse our full thickened foods and beverages collection. Free shipping on orders $75+, automatically applied at checkout. A case of thickened water or a few canisters of thickener plus other things you already buy often gets you there.
Questions about an order? Call us at 866-420-6997.
