Medical Conditions

Separation Anxiety

What is Separation Anxiety?

Separation Anxiety is a developmental disorder or stage where a child will get extremely agitated and anxious when separated from his or her mother, father or other care-giver.

What Causes Separation Anxiety?

Separation anxiety results from a complex set of interactions between the child and parent or care-giver. Every infant is different and every parent or care-giver is different. Therefore, every interaction between the child and the parent is different. As you and your child develop an emotional attachment toward one another, your child's temperament will partially determine how he or she will respond when there is a separation between the two of you. It is not unusual to feel guilty about this common occurrence.

In order for children to become anxious about separation, they must first establish a significant attachment with their parent. The infant accumulates an increasingly sophisticated repertoire of memories of the parent. In a short time, your child will begin to compare these memories with the faces of other people that he or she encounters. Your child may develop a certain level of stranger anxiety in addition to separation anxiety.

Who gets Separation Anxiety?

Most often, children between 7 and 18 months of age will experience varying degrees of separation anxiety. However, separation anxiety may return to children at an older age during emotional or stressful times or during unfamiliar situations.

What are the Symptoms of Separation Anxiety?

A child suffering from separation anxiety may show extreme and excessive emotion or distress when separated from his or her parent or care-giver. Since your child has already had an opportunity to bond with you, he or she may have difficulty developing a level of trust with a stranger in a short period of time.

As a child gets older, she or he may be exposed to new situations that require prolonged separation from the parent, i.e. child care or school. The child may even resist going to school or elsewhere due to the anxiety. There may also be a fear that you will be harmed. Children may occasionally develop sleep problems, including nightmares or sleep refusal.

How is Separation Anxiety Diagnosed?

Separation anxiety is a normal developmental condition. There are no tests for diagnosis. However, if anxiety persists beyond age 2 years, an evaluation with your child's health care provider may be necessary.

How is Separation Anxiety Treated?

This condition can be quite disconcerting to parents and it is important to remember that separation anxiety is fairly universal among babies and toddlers. It would be natural for a baby to get upset when he or she has been separated from the individual(s) with whom he or she has already bonded. The presence of separation anxiety should be a clue that you have succeeded in helping your child develop normally in the attachment process.

Your baby has been developing strong bonds with you over many months. It is important to realize that the treatment of separation anxiety is a gradual process, often requiring many months for your child to get comfortable with other caretakers. This is partly due to your child's developmental stage in life. In fact, developmental behaviorists recognize that children may not develop object constancy (retain a stable image of his/her mother when she is absent) until 3 years of age.

As adults, we look for familiar patterns to comfort us whenever we encounter a unique or new situation. Our task with our young child should include the establishment of familiarity. Ask a new sitter to visit with you and the baby before leaving your child alone with him or her. Visit a nursery, church or health club center ahead of time before you make the initial separation. Leave a picture of yourself as well as a familiar toy, blanket (transitional objects) or a piece of your clothing from home. However, once you leave the location, you should leave without returning repeatedly. Creative mothers have used technology to bring themselves to their baby, making home videos of themselves doing routine tasks so that they can leave the video with a caretaker.

As a child gets older, it is important to prepare him or her for separations. Let her know ahead of time that there will be a time of separation and ask her to partner with you in finding familiar objects or circumstances that will help her to feel more comfortable with the temporary separation.


Simons, RC; Pardes, H; Understanding Human Behavior in Health and Illness, 1977, 1985, Williams & Wilkens

Reviewed by: Noah Makovsky MD

This Article contains the comments, views and opinions of the Author at the time of its writing and may not necessarily reflect the views of Pediatric Web, Inc., its officers, directors, affiliates or agents. No claim is made by Pediatric Web, the Author, or the Authors medical practice regarding the effectiveness and reliability of the statements contained herein and such individuals and entities disclaim any and all liability for the comments and statements contained in this Article and for any use or misuse of the statements made in this article in any specific medical situations. Further, this Article is intended to be general in nature and shall not be considered medical advice. The statements made are not to be utilized to diagnose and/or treat any individuals medical symptoms. If you or someone you know has symptoms which you believe are similar to this Article, you should discuss such symptoms with your personal physician or other qualified medical practitioner.

Copyright 2012 Pediatric Web, Inc., by Dan Feiten, M.D. All Rights Reserved

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