Hi Sara,

Great advice from the other moms. When my daughter was a baby this was my main concern. I agree that fever and stomach bugs are the main thing to be concerned about and watch your dauther closely. We were told that when she is sick to make sure that she can be awoken even at night. So we would set the alarm clock and wake the poor thing up all night! But better safe than sorry. The first time we gave the shot we were so nervous. WE waited to make sure she really needed it....well she responded so beautifully and quickly that we wondered what all the fuss was about. Now we don’t think twice about it. If she has a fever for a day and it spikes we give her the shot as we know with experience with her that the oral meds are not being absorbed and her fever will eventually cause her to vomit a foamy very scary vomit that is definately sign of adrenal crisis. WE also give it to her with vomiting or diarrhea. It’s weird for my duaghter but if she has a stomach thing, even if it’s not a constant vomiting or diarrhea (it need be only once with our dauther) then she could be plunging into an adrenal crisis. For example, one day she complained her stomach hurt. In the evening she had one little touch of diarrhea. We figured, well she didn’t lose a bunch of water so we didn’t give her the shot. Well, in the morning she barely woke up and collapsed in my arms where we immediately gave her the shot. All CAH kids respond differently in different circumstances. I know your daughter is young but together you will learn how she responds to illnesses. Best advice is be prepared; practice giving the shot on a grapefruit, and look carefully for signs that she is not doing well. Some signs are lethargy (limp, grey, weak, shaking, stomach ache, unable to focus eyes), fever, projectile vomiting, diarrhea, broken bone, etc. For an infant, know that she will let you know by either excessive crying for fever etc. (Use advil/tylenol to bring fever down fast. If fever won’t go down, give the shot). Of course, you should ask your endo about all of this and follow his/her advice. I am just telling you what we have experienced. If your endo won’t prescribe the solucortef shot...find one that will. Take care, Julia