A milkshake is a sweet, cold beverage which is usually made from milk, ice cream, or iced milk, and flavorings or sweeteners such as butterscotch, caramel sauce, chocolate sauce, or fruit syrup. Outside the United States, milkshakes using ice cream or iced milk are sometimes called a thick milkshake or thick shake; in New England, the term frappe may be used to differentiate it from thinner forms of flavored milk.

Full-service restaurants, soda fountains, and diners usually prepare and mix the shake “by hand” from scoops of ice cream and milk in a blender or drink mixer using a stainless steel cup. Many fast food outlets do not make shakes by hand with ice cream. Instead, they make shakes in automatic milkshake machines which freeze and serve a premade milkshake mixture consisting of milk, a sweetened flavoring agent, and a thickening agent. However, some fast food outlets still follow the traditional method, and some serve milkshakes which are prepared by blending soft-serve ice cream (or ice milk) with flavoring or syrups. Milkshakes can also be made at home with a blender or automatic drink mixer.

A milkshake can also be made by adding powder into fresh milk and stirring the powder into the milk. Milkshakes made in this way can come in a variety of flavors, including chocolate, caramel, strawberry, and banana.

Hand-blended milkshakes are traditionally made from any flavor of ice cream; additional flavorings, such as chocolate syrup and/or malt syrup or malt powder, can be added prior to mixing. This allows a greater variety than is available in machine-made shakes. Some unusual milkshake recipes exclude ice cream.

Milkshake-like recipes which use a high proportion of fruit and no ice cream are usually called smoothies, even if frozen yogurt (a dairy dessert) is used; however there are cases where a blended beverage is made with sherbet, frozen yogurt and fruit which are sold as smoothies even though they could also be considered milkshakes. When malted milk is added, a milkshake is called a malted milkshake, a malt shake (or maltshake), a malted, or simply a malt. An ice cream-based milkshake may be called a thick milkshake or thick shake in the United Kingdom or a frappe (pronounced “frap-PAY” (/fɹæˈpeɪ/) or “frap”) in parts of New England and Canada.In Rhode Island and Southeastern Massachusetts, coffee syrup or coffee-flavored ice cream is used to make the local “coffee cabinet” shake. Milkshakes with added fruit called batido are popular in Latin America and in Miami’s Cuban expatriate community. In Nicaragua, milkshakes are called leche malteada.

Some U.S. restaurants serve milkshakes with crumbled cookies, candy bar pieces, or alcoholic beverages. The grasshopper milkshake, for example, includes crumbled chocolate cookies, creme de menthe liqueur, and chocolate mint ice cream.

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