Our endo says to double the dose if the fever is over 100 degrees F, if they have a bad nose/throat cold, or any infection that would keep them home from school. Actually, Karen, our CAH kids' glands (adrenals) do not produce the hormones that they need to deal with infections AT ALL! That is why we give them the meds by mouth. During infection or any type of physiological stress (like breaking a bone or surgery) a "normal" person's body would produce extra cortisol to help the body deal with the extra stress; our kids' bodies don't do this, so we give them double or triple doses to mimic the body's response. That is also why we give them injections when they can't keep it down because of vomiting or diarrhea, or when they just seem "sick" - the result of not enough cortisone can be adrenal crisis and death! You'll do just fine! Keep on reading and asking questions! God bless!