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Optimal practice review: recommendation reminders detail

Recommendation reminder 3: Dicycloverine (dicyclomine) should not be used in the treatment of colic due to side effects such as breathing difficulties and coma.

Guidance:Postnatal care
Date issued:July 2006

Postnatal care refers to the care of women and their babies in the first 6–8 weeks after birth. Because each woman and baby has different needs, the postnatal care they receive will vary.

For most women and babies the postnatal period is uncomplicated and postnatal care is primarily about providing a supportive environment in which a woman, her baby and the wider family can begin their new life together. Postnatal care is also about ensuring that the mother and baby are recovering normally after the birth and being able to quickly identify and deal with any problems that might occur.

The majority of postnatal care takes place in the woman’s home and is likely to include routine clinical examination and observation of the woman and her baby, routine infant screening to detect potential disorders, support for infant feeding and ongoing provision of information and support.

Colic is excessive crying in otherwise healthy infants and is a common problem. The condition normally starts a few weeks after birth, and continues for the first three to four months of life. Although it may appear that the baby is in distress, colic is not harmful. Parents of a healthy baby who has colic should be reassured that colic is usually a phase that will pass. Holding the baby through the crying episode, speaking to other people in the same situation or using a special type of formula milk in a bottle-fed baby may help.

Dicycloverine belongs to a group of medicines known as antimuscarinics. It is used to relieve stomach cramps and has also been used to treat colic. The literature reviewed by the NICE Guideline Development Group on the effectiveness of treatments for colic (including diets, drug treatment and behavioural interventions) indicated that drug treatment with dicycloverine showed clear benefit. In addition, clinical trials indicated that dicycloverine performed significantly better than placebo (no treatment) in the treatment of colic.

However, the evidence showed that dicycloverine is associated with side effects including breathing difficulties, seizures and coma. These side effects led the manufacturers of dicycloverine to state that it cannot be used in infants less than 6 months old.

Therefore, as a result of this evidence that dicycloverine has the potential to cause serious side effects such as breathing difficulties and coma, NICE recommends that it should not be used in the treatment of colic.

This page was last updated: 15 October 2009

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.