The information presented is intended for general information and
educational purposes. It is not intended to replace the advice of your
health care provider. Contact your health care provider if you believe
you have a health problem.
X32794 (Rev. 05/2020) ©AAHC Dysphagia
Free Water Protocol
Purpose of the free water protocol:
• To improve oral hydration in patients with
dysphagia (swallowing problems) who must
thicken all liquids
• To make it easier to follow feeding/swallowing
guidelines with thickened liquids
The idea behind the free water protocol is that water
has a neutral pH and is free of bacteria. Drinking
other thin liquids (example: juice) can lead to
respiratory infections and pneumonia.
Even though water is free and clear of bacteria, there
are several guidelines that must be followed when
drinking thin water in order to prevent respiratory
infections/pneumonia.
Guidelines: You may have THIN WATER according
to the rules below:
1. You must do THOROUGH ORAL CARES (full
brushing of the teeth, tongue, and insides of
cheeks) first thing in the morning and after each
meal or snack before drinking thin water.
2. Thin water is allowed BETWEEN MEALS/
SNACKS. Do not drink thin water during a meal
or snack. During meals/snacks all liquids need to
be thickened.
3. Anytime you have THIN WATER there should
NOT be ANY other foods or liquids present.
4. All other liquids (example: juice, coffee, soda,
milk, etc.) must be thickened.
5. DO NOT TAKE medications with thin water.
Medications may be taken with thickened water.
Thorough oral cares must be done after taking
medications if you want to drink thin water
afterwards.
6. Follow all other swallowing guidelines
recommended by your speech pathologist.
