Separation anxiety in infants peaks at about

Separation anxiety is fussing and crying when a parent leaves the room. Some children scream and have tantrums, refuse to leave their parents' side, and/or have nighttime awakenings.

Separation anxiety occurs when infants begin to understand that they are a separate person from their primary caregiver but still have not mastered the concept of object permanence—the idea that something still exists when it is not seen or heard. Thus, when infants are separated from their primary caregiver, they do not understand that the caregiver will return. Because infants do not have a concept of time, they fear that the departure of their parents is permanent. Separation anxiety resolves as children develop a sense of memory. They can keep an image of their parents in mind when the parents are gone and can recall that in the past, the parents returned.

Parents should be advised not to limit or forego separations in response to separation anxiety; this response could compromise the child’s maturation and development. When parents leave the home (or leave the child at a child care center), they can try the following strategies:

• Encouraging the person caring for the child to create distractions

• Leaving without responding at length to a child’s crying

• Remaining calm and reassuring

• Establishing routines at separations to ease the child’s anxiety

• Feeding the child and letting the child nap before parents leave (because separation anxiety may be worse when a child is hungry or tired)

If the parents must momentarily go to another room in the home, they should call to the child while in the other room to reassure the child. This strategy gradually teaches the child that parents are still present even though the child cannot see them.

Separation anxiety causes no long-term harm to children if it resolves by age 2 years. If it persists beyond age 2, separation anxiety may or may not be a problem depending how much it interferes with the child’s development.

Stranger anxiety is manifested by crying when an unfamiliar person approaches. It is normal when it starts at about 8 to 9 months and usually abates by age 2 years. Stranger anxiety is linked with the infant’s developmental task of distinguishing the familiar from the unfamiliar. Both the duration and intensity of the anxiety vary greatly among children.

Common sense should dictate management. If a new sitter is coming, having that person spend some time with the family before the actual day makes sense. When the event arrives, having parents spend some time with the child and sitter before they leave is prudent. If grandparents are coming to watch the child for a few days while parents go away, they should arrive a day or two early. Similar techniques can be used in anticipation of hospitalization.

Babies and toddlers often get clingy and cry if you or their other carers leave them, even for a short time.

Separation anxiety and fear of strangers is common in young children between the ages of 6 months and 3 years, but it's a normal part of your child's development and they usually grow out of it.

Why separation anxiety happens

If your baby used to be calm when you left the room and they were happy to be held by people they didn't know, it may not seem to make sense when they start crying whenever you're not there or strangers are close.

But separation anxiety is a sign your baby now realises how dependent they are on the people who care for them. That can include their grandparents or professionals closely involved with their care, as well as their parents.

As they get more aware of their surroundings, your baby's strong relationship with this small group means they don't feel so safe without you. Their growing awareness of the world around them can also make them feel unsafe or upset in new situations or with new people, even if you are there.

How to handle separation anxiety

Separation anxiety can make it difficult to leave your baby at nursery or in someone else's care. You may feel distressed by their tears and worry about the effect on your baby every time you need to leave them.

Remember, it's only natural for your baby to feel anxious without you, so there's no reason to feel guilty when you need to get on with other parts of your life. In fact, separation anxiety is usually a sign of how well you have bonded with them.

Instead, you can focus on helping your baby understand and deal with their feelings so they feel more secure. They'll learn that if you leave them, they will be OK and you will come back. If your baby's old enough, you can talk to them about what's happening, where you're going and when you'll be with them again.

By leaving your baby with another caregiver, you won't damage them. You're actually helping them learn to cope without you, and that's an important step towards their growing independence. Don't be too hard on yourself – separation anxiety is common and it's normal.

Tips for separation anxiety

Practise short separations from your baby to begin with

You could start by leaving them in someone else's care for a few minutes while you nip to the local shop. Leave your baby with someone they know well so they still feel comfortable and safe in your absence. Gradually work towards longer separations, and then leaving them in less familiar settings.

Talk about what you'll do together later

Talk to your toddler about what you're going to do when you see them again so they have something to look forward to with you. For example, you could say: "When Mummy comes back to pick you up, we'll go to the shop together to get food for dinner."

Leave something comforting with your baby

It may comfort your baby to have something they identify with you – like a scarf with your scent on or a favourite toy – close by. This may reassure them while you are away.

Make saying goodbye a positive time

When you leave your baby, however sad or worried you may be feeling, smile and wave goodbye confidently and happily, otherwise they will pick up on your tension. By giving your baby experience of saying goodbye then having happy reunions, you are teaching them an important life lesson.

When to get help for separation anxiety

It's completely natural for babies and toddlers to cry when they part from their main caregiver. But as babies get older, they're more able to understand that people and things exist even when they can't see them.

Until that happens, it's important your baby's anxiety doesn't stop them getting the most from new experiences like socialising and learning at nursery. And it shouldn't stop you going to work.

If your child's separation anxiety is causing them a lot of distress, they are upset for a long time after you have left them, or it has been going on for more than a few weeks, talk to your health visitor.