Can I use banana puree as a thickener?
When babies are having difficulty eating, especially if they are letting milk get into their airways, speech language pathologists may recommend thickening liquids. This can slow things down and give babies both extra time and more awareness of what they are drinking, which sometimes helps them keep milk from going down “the wrong way”.
Banana puree is cheap and thickens well
There are a bunch of different products that are used to thicken liquids, and to be honest, they all have drawbacks. When we add anything to breastmilk or formula, we are messing with the nutritional content. Babies can gain weight but not have enough of the right kinds of vitamins, proteins, and minerals for their bodies to develop. Too-early introduction of solids is linked to obesity, diabetes, and celiac disease. Some gel-based thickeners are expensive and risky for preterm infants. Rice cereal is not recommended because of the arsenic content. Over time, oatmeal thickens too much in formula and dissolves in breast milk. Most thickeners seem to change pooping and impact on digestion.
All that said, when a baby is aspirating (letting milk get into their airway), thickening can sometimes be the safest option.*
Practitioners and researchers are experimenting with using banana puree as a thickener, and have found that it works quite well to get the right thickness. The “recipes” depend on the kind of milk used, so ask your speech language pathologist to walk you through an IDDSI test with whatever your baby is eating. I’m planning to post on how to do an IDDSI test soon, but here’s a youtube link in the meantime.
But ask for help monitoring potassium
The main caution with banana puree is that it has a lot of potassium in it, and too much potassium is not good for a baby. As in, it is dangerous. The recommendation is to “restrict banana puree to 15% of feeding volumes”, which to me means asking your doctor to give guidance for your baby since I don’t feel comfortable doing that math.
If you are interested in using banana puree as a thickener, ask your SLP and doctor about it. I’ve linked an article below with details about how to mix to get different thicknesses and how to manage amounts so that your baby isn’t getting too much potassium. As of today, the article is free and you can print it or email to your medical team. Using banana is a new enough option that they may not have the information memorized.
*I do say sometimes. Not always. And thicker does not mean safer. Your baby should not be put on a thickened liquid without an instrumental swallow evaluation, either a modified barium swallow study or a flexible endoscopic evaluation of swallow.
References
Brinker K, Winn L, Woodbury AE, et al. The nutrition profile and utility of banana puree as a liquid thickener for medically complex infants with dysphagia. Nutr Clin Pract. 2025;40:227‐238. doi:10.1002/ncp.11240
link: https://aspenjournals.onlinelibrary.wiley.com/doi/full/10.1002/ncp.11240