Central diabetes insidus (CDI) neonatal age can be a result of intracranial insult, either congenital or acquired. The management CDI in this age group poses special set of problems owing to obligate high water intake in milk-based feeds. Due to the risk of hyponatremia on long term anti diuretic hormone (ADH), these babies should be managed on high volume of feeds with low content of renal solute load (RSL). Addition of thiazides may decrease the fluid requirements in these babies. We report the challenges in management of CDI in a male newborn with underlying semilobar holoprosencephaly. The water and solute balance in such babies on different type of feeding options is discussed.