little girl hugging her mother

Separation anxiety is an anxious response to being separated from — or the threat of being separated from — a parent or another important caregiver.

It is a normal development stage first observed in babies around nine months of age. Children usually outgrow separation anxiety in their second year of life.

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Symptoms of Separation Anxiety

Your child may get tense, act shy, cry, throw a tantrum, cling, or search for you when you are gone or out of sight or when they think you may be leaving.

Other symptoms may include:

  • Refusing to go to school or do things that require being away from you.
  • Physical illness, such as headaches or vomiting.
  • Poor school performance.
  • Failing to have healthy interactions with other children.

Reactions by Age and Temperament

Your child’s reactions may vary by age based on achieving certain developmental milestones. Severity can range widely and depends on many factors, including your child’s temperament.


When babies are very young, they may have anxious, distressed reactions when they realize their caregiver is gone. At around eight months of age, babies begin to develop an understanding of object permanence. That’s the ability to know that objects continue to exist even though they’re no longer seen or heard. Examples include a toy placed under a blanket or your face hidden behind your hands in a game of peek-a-boo.


As toddlers, children become more independent and adventurous. But toddlers are more aware of and uncertain about separations. Their reactions may be loud, dramatic, and hard to stop.


Once a child reaches preschool (around age 3), their reactions may be more behavioral. They’re aiming to control the situation in order to get what they want.

No matter your child’s age or developmental stage, seeing your child upset can be difficult and distressing for you. It’s best if you can keep your emotions in check (or at least appear as if you can.)

Once you leave successfully, it’s OK to check that everything’s fine at home. But if your child sees you, you may have to restart the whole separation process.

Strategies for a Successful Separation

Here are some helpful strategies to try:

Establish Routines

  • Say good-bye. Focus on your child and be affectionate. You could give a hug and a kiss, wave, or even a special saying or silly little song — something positive and reassuring for both of you. As tempting as it may be, don’t make a habit of sneaking out. This vanishing act can lead to prolonged distress. Your child may search for you and have increased anxiety with future separations.
  • Say hello. Enjoy the excitement of the reunion. Take your child’s lead on the homecoming — it may be a big hug, playing a favorite game, or another way to share this special moment.
  • Say goodnight. Bedtime routines should be relaxing and predictable. They should help prepare your child to transition from the day’s activities into a restful night’s sleep.

Be Consistent

Leave or return at the same time and maintain routines as much as possible.

Send a clear, firm message

Discuss when you’ll be leaving and when you will return — then keep your promises. The message should be developmentally appropriate. An older child may understand time. But it may be better to frame when you plan to leave or come back around regular routines, such as after a nap, before dinner, and after bedtime.

Be quick

Don’t repeatedly delay the departure to reassure your child. A long goodbye will just prolong the process and may increase everyone’s distress.

Identify a support or comfort item

Pick a favorite toy or stuffed animal, pictures, or a voice recording or video. It should be something your child can use for reassurance or something that sparks a feeling of happiness.


This reinforces object permanence and that you will return even if your child doesn’t see you. Start by leaving your child with a babysitter or family member for short periods. Children who have other caregivers early on in life seem to have a better acceptance of separation later.

Pay attention to timing

Isn’t everything worse when you’re tired, hungry, or not feeling well? The same goes for your child. Try to plan around these issues when leaving.

Separation anxiety usually doesn’t last past the preschool years. But older children and adults can continue to experience symptoms. Separation anxiety in older children and adults may be a problem that should be evaluated and treated.

If these strategies don’t work, additional resources and approaches may help. At any age, if separation anxiety is interfering with daily life, talk to your pediatrician or primary care provider.

Bowlby's Stages of Attachment. Encyclopedia of Child Behavior and Development. Link.

A Critical Exploration of Child-Parent Attachment as a Contextual Construct. Behavioral Sciences. Link.

Secure Attachment. APA Dictionary of Psychology. Link.

Insecure Attachment. APA Dictionary of Pscyhology. Link.

Ambivalent Attachment. APA Dictionary of Psychology. Link.

Avoidant Attachment. APA Dictionary of Psychology. Link.

Anxious-Avoidant Attachment. APA Dictionary of Psychology. Link.

Anxious-Resistant Attachment. APA Dictionary of Pscyhology. Link.

Attachment Style. APA Dictionary of Psychology. Link.

Disorganized Attachment. APA Dictionary of Psychology. Link.

Infant Attachment: What We Know Now. U.S. Department of Health and Human Services. Link. (This report is from 1991)

B. Rose Huber. Four in 10 Infants Lack Strong Parental Attachment. Woodrow Wilson School of Public and International Affairs. Princeton University. 2014. Link.

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.