My son with CAH is also 8 months and I am still confused about this also. He got bronchiolitis about 2 months ago and has had cold-like symptoms (cough, runny nose, occasional fever) ever since. After much thought on this and discussions with my pediatrician and endo here is basically what I have come up with: Acting really sick (crying a lot, lethargic, etc...) and/or fever above 100: Triple dose Acting like he is not feeling great but no fever: Double dose Runny nose, cough but happy and smiley: usual dose If you're not sure it is always best to give too much. And I also think it is good to check with your endo. Mine is always really helpful with comments like "give it if you think he needs it". Sometimes I feel like I am making it up as I go along. According to everyone it gets easier. I can't wait!