For a study, researchers sought to determine how free water affected clinical outcomes in medically complicated patients. The hypothesis was that patients who received more thin liquids had worse results due to an increased risk of gastric reflux. From 2010 to 2019, a retrospective chart review of children who were started on commercial blenderized tube feedings was conducted. Based on the International Dysphagia Diet Standardization Initiative (IDDSI) framework, the percentage of a thin liquid’s gastrostomy intake was calculated. Thin liquids include free water or light formula. Patients were divided into 2 groups: those who received low volumes of thin liquids (percent skinny ≤20%) and those who received higher volumes (percent light>20%). During the year after the commencement of the mix, emergency room visits, hospital admissions, and chest X-rays were compared. The study comprised 45 individuals ranging in age from 12 months to 18.7 years (median 3.7 years). About 20 patients (44%) were given a thin-consistency blend, while 25 patients (56%) were given a thicker mixture. Patients also got 320 mL of water per day (range 0–1000 mL) in addition to the blend. Patients who consumed less than 20% thin liquids were less likely than those who consumed more thin beverages to have chest X-rays during follow-up (10% in the minimal, narrow group versus 48% in the more excellent light group, P=0.03). After correcting for underlying pulmonary disease, aspiration, route of feed administration (bolus or continuous feeds), fundoplication status, and oral intake status in a multivariable logistic regression, the link remained significant. According to the research, patients on blenderized tube feed receive widely varying volumes of additional thin liquids, such as water. While the water was generally added to tube feeds for hydration, it might affect feed viscosity and clinical outcomes, such as chest X-ray performance.