Separation Anxiety in Babies: When It Starts, Signs and Bedtime

When does separation anxiety start in babies?

Separation anxiety starts as early as 4 to 5 months in some babies, but most develop a stronger separation anxiety at around 9 months, the American Academy of Pediatrics (AAP) says.

Nemours KidsHealth says separation anxiety develops between 8 months and 1 year, and the MSD Manual, a peer-reviewed clinical reference, says it typically begins at about 8 months.

Age	What typically happens	Source
4 to 5 months	Some babies already show separation anxiety	AAP
6 months to 3 years	Separation anxiety and fear of strangers are common	NHS
About 8 months	Separation anxiety typically begins	MSD Manual
About 8 to 9 months	Stranger anxiety is normal when it starts at this age	MSD Manual
Around 9 months	Most babies develop stronger separation anxiety	AAP
10 to 18 months	Separation anxiety usually peaks	AAP and MSD Manual
Around the second birthday	Separation anxiety usually fades	AAP
By age 2	Stranger anxiety usually abates	MSD Manual

The AAP says separation anxiety develops after a baby gains an understanding of object permanence, which KidsHealth describes as realizing that people still exist when out of sight and places between 4 and 7 months. Babies don't yet understand the concept of time, KidsHealth explains, so they don't know that a parent who has left will come back.

KidsHealth says some children might go through separation anxiety later, between 18 months and 2½ years, and some never experience it. The NHS says separation anxiety is usually a sign of how well you have bonded with your baby; secure attachment in the first year covers how that bond forms.

What are the signs of separation anxiety in babies?

The main sign of separation anxiety is fussing and crying when a parent leaves the room, the MSD Manual says, and some children scream, have tantrums, refuse to leave their parents' side or wake at night.

The Centers for Disease Control and Prevention (CDC) lists "reacts when you leave (looks, reaches for you, or cries)" among its milestones by 9 months. The AAP describes babies of 8 to 12 months who fuss and cry every time you leave their sight, even to go to the next room, and says leave-taking can be worse when a baby is hungry, tired or not feeling well.

At night, the AAP says a child with separation anxiety may wake several times and cry anxiously for one or both parents, often with a strong preference for one. At bedtime, the AAP adds, a baby may refuse to leave you to go to sleep.

Is separation anxiety at night the 8-month sleep regression?

KidsHealth says some babies in the second half of the first year may call out or cry in the middle of the night, then calm down when a parent enters the room, and that this is due to separation anxiety, a normal stage of development; none of the AAP, NHS, CDC, KidsHealth or MSD Manual pages cited here uses the term "8-month sleep regression."

The AAP says that from the second half of the first year, separation anxiety can cause many nights of disrupted sleep, in a stage that can last for several months.

KidsHealth says most babies 8 to 12 months old should sleep 12 to 16 hours a day, including a stretch of 9 to 12 hours at night; how much sleep is normal gives the hours for other ages.

When does stranger anxiety start, and how is it different?

Stranger anxiety is normal when it starts at about 8 to 9 months and usually abates by age 2, according to the MSD Manual, and it shows as crying when an unfamiliar person approaches.

The CDC lists being "shy, clingy, or fearful around strangers" among its milestones by 9 months. The AAP's guidance for 8 to 12 months says even relatives and frequent babysitters a baby was once comfortable with may prompt them to hide or cry, especially if they approach hastily.

The MSD Manual describes separation anxiety as a reaction to a parent leaving the room, and links stranger anxiety to a baby's task of telling the familiar from the unfamiliar. For a new sitter, it suggests that person spends some time with the family before the day itself.

How long does separation anxiety last?

Separation anxiety usually peaks between 10 and 18 months, both the AAP and the MSD Manual say, and the AAP says it usually fades around the second birthday. The MSD Manual says it generally resolves by 24 months.

The NHS says it is common up to 3 years and can last longer, and KidsHealth says that, depending on temperament, it can in some cases last from infancy through the elementary school years. The AAP says it is rare for separation anxiety to persist on a daily basis after the preschool years.

How do you handle separation anxiety at goodbyes and bedtime?

Keep goodbyes short and consistent, the AAP advises, and at night KidsHealth suggests reassuring your baby quietly that you're there, then leaving again.

At goodbyes

• Give your full attention and affection, then say goodbye quickly. The AAP says that if you linger, so does the anxiety.
• Use the same ritual at the same time each day, as the AAP suggests.
• Smile and wave goodbye confidently, however you feel. The NHS says babies otherwise pick up on your tension.
• When you say you're leaving, mean it. KidsHealth says coming back will only make things worse.
• Leave after naps and meals rather than when your baby is tired, hungry or restless, KidsHealth suggests.
• Practice with peek-a-boo and short separations with someone your baby knows well, as the NHS suggests.
• Leave something comforting, such as a scarf with your scent on it, which the NHS says may reassure your baby while you're away.

The AAP says a baby's tears will subside within minutes of your departure. KidsHealth suggests trying not to start childcare with an unfamiliar person between 8 months and 1 year, when separation anxiety is first likely to appear.

At bedtime and at night

If your baby cries after being put down, KidsHealth suggests staying away for a few minutes, then soothing them for a moment without picking them up, as long as you know they are safe and not hungry, wet, soiled or unwell.

When your baby wakes and cries for you, KidsHealth suggests quiet reassurance that you're there, then a soothing pat on the back and a quick exit. KidsHealth notes that cuddling, feeding or talking at those wakings may prompt your baby to wake regularly for that attention; night weaning covers whether a baby this age still needs night feeds.

The AAP says the stage needs a loving and consistent approach, and that your child may need reassurance several times, night after night, until it fades.

Keep comfort objects, a scarf with your scent included, out of the crib: KidsHealth's sleep guidance for 8 to 12 months says not to put anything else in the crib or bassinet, and to keep plush toys, pillows, blankets, unfitted sheets, quilts, comforters, sheepskins and bumper pads out of your baby's sleep area. Safe sleep practices covers the rest of a safe sleep space.

When should you call your pediatrician?

Talk to your pediatrician if you are concerned your child isn't adapting to being without you, the AAP says. The other sources add these reasons to get help:

• Separation anxiety is causing your child a lot of distress, they stay upset for a long time after you leave, or it has gone on for more than a few weeks. The NHS lists these as reasons to talk to a health visitor.
• Intense separation anxiety lasts into preschool or beyond and interferes with daily activities (KidsHealth).
• In an older child: panic symptoms before a parent leaves, nightmares about separation, or excessive worry about being lost or kidnapped (KidsHealth).
• Stranger anxiety is of pronounced intensity or extended duration, which the MSD Manual says should prompt an evaluation.