Separation anxiety is the fear young children have that their parents will leave them.

• Separation anxiety typically starts around age 8 months and is most intense between 10 months and 18 months.
• Separation anxiety begins to resolve as children age and begin to remember that parents return after leaving.
• Separation anxiety usually stops by age 2 years.

Children with separation anxiety panic and cry when a parent leaves them, even if only to go into an adjacent room. Separation anxiety is normal for infants at about 8 months of age, is most intense between 10 months and 18 months of age, and usually resolves by 2 years of age. The intensity and duration of a child's separation anxiety vary and depend partly on the child-parent relationship. Usually, separation anxiety in a child with a strong and healthy attachment to a parent resolves sooner than in a child whose connection is less strong.

Separation anxiety occurs at a time when infants start to become aware that their parents are unique individuals. Because they have incomplete memory and no sense of time, these young children fear any departure of their parents may be permanent. Separation anxiety resolves as a young child develops a sense of memory and keeps an image of the parents in mind when they are gone. The child recollects that in the past the parents returned.

Parents should not limit or forego separations in response to separation anxiety because doing so could compromise the child's maturation and development. When parents are ready to leave the home (or leave the child at a child care center), they should encourage the person with whom they are leaving the child to distract the child with toys, a game, or another activity. Then, the parents should leave without responding at length to the child's crying. If the parents are staying at home but in a different room, they should not return immediately in response to crying, but instead should call to the child from the other room. This teaches the child that parents are still present even though the child cannot see them. Separation anxiety may be worse when children are hungry or tired, so feeding children and letting them nap before leaving may also help.

Separation anxiety at the normal age causes no long-term harm to the child. Separation anxiety that lasts beyond age 2 may or may not be a problem depending on the extent to which it interferes with the child's development. It is normal for children to feel some fear when leaving for preschool or kindergarten. This feeling should diminish with time. Rarely, excessive fear of separations inhibits a child from attending child care or preschool or keeps a child from playing normally with peers. This anxiety is probably abnormal (separation anxiety disorder—see Mental Health Disorders in Children: Separation Anxiety Disorder). In this case, the parents should seek medical attention for the child.

Last full review/revision February 2009 by Elizabeth J. Palumbo, MD