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I have two kids with SWCAH and we give the solucortef at home (via intramuscular injection) if they are vomiting too much to keep their oral medication down. We do try and give an oral dose a couple of times and if it is clear that it won't stay down we give the injection. We usually avoid the hospital if we can. Most times the injection is enough to get them over the rough patch and they become well enough to resume their oral doses of medication. As all kids are different I find that the best way is to use what advice you get from here as a guide but trust your own instincts with your children as you know them best. Good luck