Soft diet < 5 years

Aim

To provide a diet of soft-textured foods that can be easily chewed, requiring minimal biting and is suitable for infants and children less than 5 years.

Characteristics

Texture A – soft. Foods in this category may be naturally soft (e.g. ripe banana), or cooked or cut up to alter texture. Minimal cutting should be required. Food should be easily broken up with a fork or able to be mashed in the mouth with the tongue against the palate. Harder-textured foods (e.g. meat, fibrous particles) need to be cut into particle size less than or equal to 0.8cm for infants and children under 5 years of age (due to tracheal size of < 5 years). 0.8cm is the particle size of the final product to be presented. Note, meat pieces may shrink during cooking.

Food should be moist or served with a sauce or gravy to increase moisture content.

Sandwiches need to be without crusts and cut into quarters.

This diet texture can be applied to any portion size and most therapeutic diets.

Indications

• oral surgery
• swallowing difficulties
• poor dentition
• painful mouth, gums or tongue (e.g. mouth ulcers, or following surgery of the mouth).

Nutritional adequacy

Nutritionally adequate, but may be low in dietary fibre. Patients ordered this diet should be monitored regularly to ensure adequate dietary intake.

Precautions

All foods to be naturally soft, minced or mashed, slightly firm but not tough or stringy, and without fat, gristle or bone. This diet is not necessarily a light diet (i.e. it can be spicy). All beverages, sauces and gravies must be thickened to the appropriate level for individuals also prescribed thickened fluids.

Please note: For children 5 years and over requiring a soft diet, the soft - dysphagia diet specification from the Therapeutic diet specifications for adult inpatients is appropriate.

For infants and children requiring minced and moist (texture B) use the minced and moist - dysphagia diet specification from the Therapeutic diet specifications for adult inpatients and combine with an age appropriate diet.

For infants and children requiring smooth puree (texture C) use the smooth puree - dysphagia diet specification from the Therapeutic diet specifications for adult inpatients and combine with an age appropriate diet.

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	Soft dishes that can be mashed with a fork (e.g. tuna/salmon mornay, soft macaroni cheese, flaked fish, cottage pie, tofu) Soft dishes cut up (e.g. lasagne, smooth quiche with crumbly base, fish cakes, crêpes) Roasts diced or minced, with gravy (< 0.8cm particle size) Well-cooked legumes (e.g. baked beans)	Sliced roast meats or grills Meat with gristle Crumbed or fried fish Dishes with hard pastry (e.g. spinach pie, regular quiche, pizza) Casseroles with large pieces (e.g. curried prawns) Dishes with crisp topping
Sauces, gravies	All	-
Starchy vegetables/pasta/rice	Mashed and scalloped potato Chopped pasta or well-cooked rice with plenty of sauce	Roast or baked (including cut up) jacket or boiled new potatoes Rice or pasta (if dry)
Vegetables	Most if soft enough to mash with fork Well-cooked, cut up and served in small pieces (≤ 0.8 x 0.8 cm)	Raw vegetables Fibrous vegetables (e.g. corn, celery, broccoli stalks)
Soups	All	-
Sandwiches	Soft sandwiches with crusts removed and cut into quarters Use moist fillings (e.g. diced or shaved chicken or ham, salmon, tuna, egg with mayonnaise)	Sandwiches with crusts or hard fillings Bread with seeds or grains
Salads, dressings	None	-
Breads, cereals	Soft sliced bread (white or wholemeal) with crusts removed and cut into quarters with spread Rolled oats, semolina, cold breakfast cereals moistened with milk, soft pancakes	Wholegrain and fruit breads and all bread rolls Hard cereals that do not soften easily (e.g. toasted muesli) Cereals with dried fruit, or seeds (e.g. Sultana Bran®, Just Right®)
Spreads	All	-
Hot breakfast choices	Scrambled or poached eggs (chopped), baked beans, canned spaghetti, creamed corn	All others (e.g. fried egg, bacon, sausages)
Fruit	Soft canned fruit (e.g. pear halves, peaches, apricots, apple) Soft bananas, well-ripened paw-paw, chopped soaked prunes	Other fresh fruit Canned pineapple, stewed rhubarb
Yoghurt	All yoghurt and Frûche® (including soft fruit)	-
Desserts	Milk-based soft dessert (e.g. custards, mousses, cut up trifle, creamy rice, puddings) Fruit crumble or plain cake with custard Ice-cream Jellied fruit with small fruit pieces (< 0.8 x 0.8cm)	Any with hard pastry Dry cakes without custard
Milk and cheese	All milk Cottage cheese, ricotta, camembert and soft cheddar (grated or soft cheese slices)	Hard cheeses Crisp cooked cheese topping on hot dishes
Beverages	All with a minimum amount of texture (pulp)	-
Biscuits	Easily crumbled biscuits (e.g. shortbread, Milk Arrowroot™, Milk Coffee™)	Hard biscuits and crackers (e.g. Anzac biscuits, Ginger Nut™ biscuits, rice crackers)
Miscellaneous	Fortified pudding supplements Soft smooth chocolate	Nuts, seeds and coconut Cake with dried fruit Hard lollies

References

1. Dietitians Association of Australia. 2009. Nutrition Manual 8th ed. Canberra: DAA.
2. Dietitians Association of Australia and The Speech Pathology Association of Australia Ltd. Texture-modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definition. Nutrition & Dietetics 2007;64 (Suppl 2): S53-S76.
3. Litman RS, Weissend EE, Shibata D, Westesson P’L (2003). Developmental changes of laryngeal dimensions in unparalysed, sedated children. Anesthesiology, 98(1): 41-45.