Separation Anxiety

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KEY POINTS

• Separation anxiety is when an infant or toddler gets upset when away from parents, or seems scared when meeting strangers. Separation anxiety is most common between 6 months and 2 years of age.
• Separation anxiety is more likely when your child is hungry, tired, or sick.
• To prevent problems, start early to help your child learn that even though you go away, you always come back.

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What is separation anxiety?

Separation anxiety is when an infant or toddler gets upset when away from parents, or seems scared when meeting strangers.

What is the cause?

Separation anxiety is a normal part of development. It is most common between 6 months and 2 years of age. Sometimes changes can cause anxiety, such as:

• A new babysitter or child care
• A new sibling
• Moving to a new place
• Stress at home

Leaving a child with a babysitter or in child care can be stressful for both parent and child. Your child may be scared when you leave her sight. You may feel anxious when you have to leave your child. Usually, even though your child cries when you leave, the tears stop within minutes.

What are the symptoms?

Symptoms may include:

• Crying when you are not in sight
• Temper tantrums
• Being clingy and wanting to be near you all the time
• Trouble falling asleep or having nightmares if you are not in the same room

How can I help my child?

• Play peek-a-boo with your baby or toddler. This helps her learn that even though you go away, you always come back.
• If your child crawls or walks to another room, don’t follow her right away. This helps her get used to the idea that you can be out of sight, but not completely gone.
• If your toddler wakes up and cries during the night, comfort your child, but make it clear that she must stay in her own bed.
• When you need to leave, try to make sure that your child has eaten and napped before you go. Separation anxiety is more likely when your child is hungry, tired, or sick.
• If child care will be provided outside the home:
  • Get your child used to someone else taking care of her for an hour or two while you are still around the house. Next, leave your home for short periods of time. Slowly build up how long you are gone. This helps you, as well as your child, get used to the idea of being apart.
  • Visit your child care provider ahead of time with your child. Help her feel comfortable. Try to keep the same child care provider. Allow your child to take a special blanket, toy, or other comfort item with her. These things can help your child feel more secure.
  • Try to stay with your child part of the first day. Try to engage your child in play with another child before you leave. When it is time to for you to go, leave as quickly and as matter-of-factly as possible. Say goodbye and give your child a quick kiss. Do not sneak away when your child is not looking.
  • Let your child know who will pick her up and when. Tell her in a way she can understand such as, “I’ll be back after your nap” or “Daddy will pick you up after your snack”. This reduces your child's fears about being abandoned. Come back when you say you are going to.
  • When you pick your child up, don't be overly emotional. It's OK to act glad to see her, but don't start crying and hugging her too much. Generally the way children handle separation reflects how you handle it. It helps if you stay calm.
  • Plan to spend some special time with your child when you get home. Praise your child’s efforts when things go well and be patient with her when they do not. Give her a hug, sing some songs, have a healthy snack, or play together. You can also read books about how other children deal with separation anxiety.

Separation anxiety is normal for very young children, but you should talk with your healthcare provider if your child is over 2 years old and:

• Has symptoms such as headaches or stomachaches when she knows you are going to leave
• Has panic symptoms such as nausea, vomiting, or shortness of breath or panic attacks when you leave
• Often has nightmares about separation
• Worries all the time about being lost or kidnapped or going places without you