Thickened Horlicks Hot Drink | IDDSI Level 2 Recipe

IDDSI Level 2 (Moderately Thick) | 15 minutes | Easy

Horlicks is one of Hong Kong’s most enduring comfort drinks — introduced to the city in the 1930s, it became a fixture of post-war Hong Kong life as a bedtime drink for children, an after-school treat, and a staple of the cha chaan teng menu. Hot Horlicks made with full-fat milk is one of the most nostalgic orders a Hong Kong resident of any age can make. In its standard preparation, Horlicks flows as a thin liquid (IDDSI Level 0), making it unsuitable without modification for individuals requiring thickened liquids. Adjusted to IDDSI Level 2 (Moderately Thick) with commercial thickener, it retains its characteristic malted milk flavour and comforting warmth while meeting dysphagia safety standards.

Ingredients (1 serving)

• 3 tablespoons Horlicks powder (approximately 25g; Original or Light both suitable)
• 180ml full-fat dairy milk (cha chaan teng style; plant-based milk can substitute but alters the flavour profile)
• 40ml hot boiled water (to pre-dissolve the powder)
• 4–6g commercial thickener powder (adjusted per product instructions to achieve IDDSI Level 2)
• 1 tsp sugar (optional; Horlicks already contains added sugar — adjust to individual preference)

Method

1. Place the Horlicks powder in a large cup or measuring jug. Add 40ml of hot boiled water and stir vigorously with a spoon until the powder is completely dissolved into a smooth paste with no dry lumps.
2. Heat milk in a small saucepan over medium heat to approximately 70–75°C (small bubbles forming at the edges but not yet simmering), or microwave for 90 seconds.
3. Slowly pour the hot milk into the dissolved Horlicks paste, stirring continuously until fully combined. Add sugar at this stage if using.
4. Confirm the mixture is lump-free; pass through a fine-mesh sieve once (Horlicks powder can leave fine granules if not fully dissolved).
5. Allow the drink to cool to below 60°C (approximately 2–3 minutes), then add the thickener powder according to the manufacturer’s Level 2 instructions.
6. Whisk briskly using a fork or electric milk frother for 20–30 seconds; stand for 2 minutes, then stir once more.
7. Perform an IDDSI syringe test (see below) to confirm Level 2 consistency, then serve warm.

Texture Test

IDDSI Level 2 (Moderately Thick) confirmation: Using a standard 10ml IDDSI syringe, fill with the thickened Horlicks and invert for 10 seconds. Between 4–8ml should flow out. The drink should move like a thin syrup — pausing briefly on a tilted spoon before sliding off slowly.

Visual test: Pour a small amount from the spoon back into the cup — the liquid should fall as a slow, thin stream rather than dropping immediately; the cup wall should show a light coating that persists briefly before running down.

Safety Notes

⚠️ Dissolve powder in hot water first — Horlicks powder does not dissolve easily in cold or warm milk alone, and can leave undissolved granules that constitute solid particles. Always pre-dissolve in hot water before adding milk, and confirm with sieving before adding thickener.

⚠️ Add thickener below 60°C — excessively hot liquid impairs some thickeners. Allow the drink to cool before adding thickener and confirm with a syringe test before each serve.

⚠️ Milk allergy and lactose intolerance — confirm that the individual has no cow’s milk protein allergy or lactose intolerance before serving. Fortified soy milk or oat milk are acceptable substitutes, but verify the suitability of the alternative within the individual’s overall dietary plan.

⚠️ Serving temperature — use a food thermometer to confirm the drink is below 60°C before serving. Excessively hot thickened liquids carry heightened scalding risk in individuals with reduced oral sensation commonly associated with dysphagia, and high heat also destabilises thickener consistency.

Sourcing in Hong Kong

• Horlicks powder: Stocked at all major supermarkets including PARKnSHOP, Wellcome, and YATA; available in Original and Less Sweet variants; larger tins (500g or above) offer better value for institutional or household use
• Full-fat milk: Supermarket chilled dairy section; full-fat (full cream) is preferred for the richest flavour closest to cha chaan teng standard; UHT full-fat milk is a practical alternative for care home pantries with limited refrigeration capacity
• Thickener powder: Pharmacies (Mannings, Watsons) or medical supply shops; confirm the product is rated for hot beverages before purchase

Nutrition

Approximately 200–230 kcal per serving (220ml), 8–10g protein, 28g carbohydrate, 280mg calcium, 1.5mg iron. Horlicks contains malted wheat and barley extract, wheat flour, and is fortified with B vitamins, vitamin C, vitamin D, calcium and iron. Full-fat milk adds additional whey and casein protein, calcium and fat-soluble vitamins. Compared with many commercial supplement drinks, thickened Horlicks delivers meaningful calories and protein in a format that elderly patients find genuinely appealing, which supports adherence — a critical factor given that uneaten supplements provide no nutritional benefit.

Cultural Note

For generations of Hong Kong residents, Horlicks carries emotional weight that few drinks can match. It is the bedtime drink their parents prepared for them as children in the 1960s and 70s, the afternoon treat from the school tuck shop, and the warm cup ordered at the cha chaan teng after a rainy evening out. In residential care settings, serving a correctly thickened Horlicks is not merely a matter of nutrition and safety — it is an act of recognition, acknowledging that elderly residents with dysphagia deserve access to the flavours that carry meaning in their personal histories. The comfort response that familiar food triggers is a documented factor in appetite stimulation and emotional wellbeing in elderly care populations.