Compulsive Water Drinking in Infants and Young Children

The management and follow-up of five patients with asymptomatic compulsive water drinking is described. Three out of the five patients were female and two were male. The age range was 6 to 20 months. All the patients presented with polyuria or polydipsia and urine osmolalities of 39 to 112 mOsm/L. The daily fluid intake ranged from 3.5 to 5 L, and the urine output was 11 to 14 mL/kg/hr. Significant improvement was noticed after a gradual weaning process. As fluid intake returned to normal, urine osmolalities reached values between 210 and 500 mOsm/L after 4 weeks, and between 630 and 800 mOsm/L after 8 weeks. No relapse was noted during the 6- to 24-month follow-up period. Pediatricians should be aware of this potentially dangerous — yet not uncommon — habit.