Oral nutritional support should involve consideration of a “Food First” approach. 
This involves the fortification of the patient’s existing diet and fluids with extra calories and protein where possible with the goal of:
- Increasing the energy and nutrient density of the food and fluids consumed.
- Increasing the frequency of consumption of food and fluids.
If the augmentation of the existing diet and fluids is insufficient, oral nutritional supplements may be appropriate to meet nutritional requirements.
Oral nutritional supplements are, in the main, prescribable products, usually in the form of milk-based or juice-based drinks, soups or desserts. These products are nutrient-dense and provide additional energy, protein and micronutrients. There are a variety of formats and flavours available, many of which are nutritionally complete. If the patient has dysphagia, liquid products may require to be thickened. It is important to consider the quantity, timing, type, and temperature served. This will support the patient to take sufficient quantities and reduce the risk of hunger.
Use of oral nutritional supplements should only be considered:
- When dietary measures alone are insufficient to maintain or improve nutritional status.
- As an addition to normal food, not as a substitute for it.
- Following assessment and prescription by a dietitian.
It is essential to monitor the effectiveness of the prescription for oral nutritional supplements in order to avoid inappropriate or unnecessary use. The patient’s nutritional status should be monitored throughout.