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Separation Anxiety

Separation anxiety and fear of strangers is common in young children.

It occurs between the ages of 6 months and 3 years. It is a normal part of your child's development.

It can happen at other times in response to stress and change, such as starting nursery or school for the first time.

Why does it happen?

Separation anxiety starts when your child understands they rely on the people who care for them.

This can include parents and other family members such as grandparents, or professionals closley involved in their care.

As children become more aware of the world around them, their strong relationship with you means they don't feel as safe without you. They can also become upset in new situations or with new people even if you are there. 

What can I do to help?

It is important to know this is a normal part of development for your child. Some children struggle more than others. It will get better in time. Here are a few tips:

  • Explain to your child what will happen and when.
  • Practice leaving them for short periods of time. This could be with someone they know for a few minutes.
  • Build up gradually to longer periods of time apart.
  • If you are leaving your child in a new place try to spend time with them there before the separation.
  • Talk about what you will do together when you get back. This will give them something to look forward to.
  • Leave something comforting and familiar with your child. For example a favourite cuddly toy, blanket, or scarf.
  • Try not to leave when your child is tired or hungry.
  • Make saying goodbye a positive time. Smile and wave goodbye confidently and happily. 
  • Be calm and consistent. Make sure you leave after saying goodbye.
  • Every child is different. Sometimes children like to be settled into an activity before you leave. Other times children respond better if you don't linger.

Watch this NHS video for more advice 'My child wants to be with me all the time. What can I do?' 

How to handle separation anxiety

Separation anxiety can make it difficult for you to leave your child at nursery or in someone else's care. You may feel upset by their tears and worry about the affect on your child.

It is natural for your child to feel anxious without you. It's normal to feel guilty when you need to get on with other parts of your life. Separation anxiety is usually a sign of how well you have bonded with your child. It's a normal part of growing up.

Focus on helping your child understand and deal with their feelings. They will learn that if you leave them, they will be OK and you will come back. If your child is old enough talk to them about what's happening, where you're going and when you'll return.

By leaving your child with another caregiver you are helping them learn to cope without you. This is an important step towards their growing independence. Don't be hard on yourself. Separation anxiety is common and is normal.

What if I need more help?

It is important that your child's anxiety doesn't stop them having new experiences, like playing with other children and learning at nursery. It should not stop you from going to work.

If your child is extremely distressed, they are upset for a long time after you have left them, or it does not improve over time, talk to your health visitor within your 0 to 19 service.

The Anna Freud National Centre for Children and Families also has further information on separation anxiety.

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.

Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand. Watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5 to19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and, or emotional health needs.

 

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Contact your local school nursing team:

Bradford School Nurses 01274 221203

Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)

Leeds School Nurses 0113 843 5683

Calderdale School Nurses 030 3330 9974 (local rate number)

Kirklees School Nurses 0300 304 5555 (local rate number)

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as:

  • loss of consciousness
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand. Watch this video with them about going to A&E or riding in an ambulance