It is very worrisome!! And a balancing act. I agree with Laurel about the suspension the pharmacy made up from the pills crushed and they added bubble gum flavoring  - it can get spoiled easily. Bacterial can grow in it and then you are giving you infant or toddler a dose of germs... NO THANK YOU!! Plus it would settle and not mix up right... then what? Are you really giving the right amount or just the favoring??

 I know too much cortef is bad. But my two year died because of this stupid suspension and the stupid doctors... saying just double the dose when she had a fever.... it wasn't working well for her without the fever and then the fever... she had no chance!! I cry for her all the time.

And there are doctors out there... that do not really monitor CAH very well... they think it is okay for six month appointments... they have a wait and see attitude.... they do not tell you to inject solu-cortef for a fever... only give it for vomiting.They don't take the right tests. They don't prescribe the right amount or kind of medications. Some kids are very mild and some kids are VERY severe (very hard to manage). Anyway... FDA --- did recall the UpJohns liquid  - it was not working. Some doctors... say twice a day on the cortef... it doesn't matter the timing... some say... it doesn't matter if you take blood or urine tests for the hormones... just go by body mass... some say!! There are so many contradictions of opoinions out there. Then the people say.. trust your own feeling...yeah right (did I go to medical school... isn't that why I am paying $200 a hour to see ped endo??).

We really need better educated doctors!! Better medications!! Doctors that will agree on how to treat CAH. Doctors that don't under estimate that it can KILL a child. It is terrible!! My daughter is dead because of this liquid and the doctor. Risk going back to it for my three year ... NEVER!! And he was failing on the UpJohn's liquid. Look at Lynn T child... he is taking growth shots because of the STUPID liquid.  Thank you but I will continue to split the pills.  I do agree that 1/4 pill does not make any sense to me.  The only reason that I am giving it a try... I feel that the only two doses at adquate or I would not even try it. Is it making him moody or crabby... it read that the people without enough cortisol are the ones with angry and emotional problems. Too much... hmm. Well at least he isn't going to die. I worry more about Not ENOUGH... than too much with my very severe salt wasting child. He is difficult to control. When the ped endo was prescibing too little cortef... I thought he would die. It was like seeing a car wreak but one that lasted for six months. .. I was lossing him. He was not gaining weight...(lossing weight)... won't eat... couldn't eat... his hair was thin, his had very dark circles under his eyes./// tired... he look and felt terrible again it was gradually but he was a baby. The 17-OHP was very high... he was not giving enough cortef on the UpJohn's liquid. I think that UpJohn's is liable !! The stupid sticky orange stuff did not work.  If I had a bottle of it now... I would throw it someone throught the computer sceen and say here  - you like ...you can have it. Then again it was working for my 7 year old (he was 3 years old at the time) but the ped endo was checking him more often than my daughter when he was a baby. With his levels finally leveling out at age 3.. then the ped endo backed off of such frequent visits for him and for my daughter (she REALLY needed more visits and tests .. rather than 6 months... just because her brother was okay.. didn't mean she was)... I didn't know any better... I trusted the doctor. What was I thinking?? Why?? It was a nightmare!! And my heart is broken. While I was pregnant this year, I had an irregular heart beat (it is better now after the baby). My three year old said... mommy has a broken heart (and I do!!).

So... anyone out there listening... don't worry as much about giving too much. ESPECIALLY IF THERE IS A FEVER - JUST INJECT THE SOLU-CORTEF !!!  At least triple the dose and reduce the fever (unless just a very mild cold without a fever). It will not hurt the child. And if you don't the child could die from an adrenal crisis... Adrenal shock.... the blood pressure will drop... the heart will stop... the brain will swell... coma... death. They can not over dose if they are ill.  Don't try to get advice over the phone... give the solu-cortef ... go to the hospital for IVs. Especially if the child is under the age of 5 years old. Don't think... hmmm, I just gave the 7 am dose and I'll wait until 3 pm or later... if there is fever at 10 am... don't wait until 3pm to increase the cortef. INCREASE immediately. A person without CAH can produce 4 to 10 times more cortisol for a fever. The CAH child can not... you must increase it for him/her.