Dear doctor;

My son drinks too much water. They say too much of anything can be bad but I am not so sure of water. The boy is just aged four but can drinks as much as two litres of water daily. Is this normal even when he is not playing so much?

James, Gasabo.

Dear James,

Is the boy drinking  more water since early childhood or has he started it recently, is there associated fever, diarrhea, vomiting, weight loss, any one or more of these symptoms?

Normally a child’s pattern of drinking water, like for eating and bowel habits takes time to set. Until then, he may drink irregularly like excess some days or go around with just drinking not even half liter of water. But a child of four years usually does not drink up to two litres of water every day. However, there are certain conditions which can predispose him for same. Hot weather, excess playing, diarrhoea, dehydration for some other reason can compel a child to drink excess water. Drugs like anti-allergy ones taken for common cold,  atropine or anti depressants can make a child feel more thirsty and drink more water. Diseases like diabetes mellitus, diabetes insipidus (disorder of hormone vasopressin which regulates water balance in body), cause excessive thirst. Diseases of the  kidney or heart can also cause excess thirst. But in these cases the features of underlying disease will overshadow excess thirst. If the child has no other problem except this, it is better to get tests done for diabetes. Avoid giving a pill for every small ailment. If problem continues, consult a paediatrician.