My son is now 8.5yrs old and we have been advised to give him 100mg in a trauma situation. When he was a baby our instruction was 50mg. Immuno-suppression is only a problem if hydrocortisone levels are elevated for a long period and my understanding is that an emergency injection has no health cost to it. As a parent the only thing that is important is that your son has had the injecion and is now safe, even if you ever give it as a precaution. Liam has never had an emergency injection to date, so, I would like to add that he is not a salt loser. If vomiting is more common for salt losers the injection advised may only be needed to re-establish maintainance levels. But I would not be happy with the 25mg advised if that included a trauma situation. Reily's scare could have been more serious if it had been a trauma. Remember your son will not over dose on hydrocortisone and never be over cautious. I would like to add one more thing that may be over pretective towards our kids. Just because someone is an endocrinologist does not mean they have expertise in CAH. Our endocrinologist in France had never had a case of CAH before, she was fantastic but we had had four years more experience, and were confident that we could deal with any situation. We check how many other CAH patients our endo has.