Separation anxiety

DEFINITION

You used to leave your baby with loved ones or other trusted child care providers with a kiss on the cheek and a quick wave goodbye. Now, however, your goodbyes trigger tears and clingy behavior. What’s going on?

Separation anxiety is a normal stage of development for infants and toddlers. Frustrating as it may be, it’s actually an emotional milestone that generally begins at 8 to 9 months of age. Your child is starting to understand that there’s only one of you — and you still exist even when you aren’t in sight.

Separation anxiety usually fades by age 24 months. In the meantime, say goodbye gently and reassure your child that you’ll return soon. Separation anxiety rarely requires medical treatment.

CAUSES

Infants and toddlers have little sense of time and few memories of past experiences. When you leave, your child may not know when — or if — you’ll return. He or she may become upset when you’re not together — even if you just step into another room for a few minutes.

Sometimes, separation anxiety can be triggered by changes in the child’s life, such as:

• A new child care situation
• A new sibling
• A new home
• Family stress or tension

SYMPTOMS

Fussing and crying are the classic signs of separation anxiety. Screaming and tantrums are possible, too. During the day, your child may refuse to leave your side. During the night, he or she may wake up and cry out for you.

Between ages 8 and 12 months, children often experience a period of separation anxiety. It usually peaks between ages 10 and 18 months. Most children outgrow separation anxiety by age 24 months.

Separation anxiety disorder

In some children, separation anxiety is a sign of a more serious condition known as separation anxiety disorder.

If your child’s separation anxiety seems intense or prolonged — especially if it interferes with school or other daily activities or includes panic attacks or other problems, he or she may have separation anxiety disorder. Most frequently this relates to the child’s anxiety about his or her parents, but it could relate to another close caregiver.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, separation anxiety disorder may occur as early as preschool age and is diagnosed when symptoms are excessive for the child’s developmental age. Symptoms may include:

• Recurrent and excessive distress about being away from home or parents
• Constant, excessive worry about losing a parent to an illness or a disaster
• Constant worry that something bad will happen, such as being lost or kidnapped, causing separation from parents
• Refusing to be away from home because of fear of separation
• Not wanting to be alone and without a parent in the house
• Repeated nightmares about separation
• Frequent complaints of headaches, stomachaches or other symptoms when separation from a parent is anticipated

When to see a doctor

If you have concerns about your child’s separation anxiety, talk to your health care provider.