My sixteen-month-old daughter has always been a pretty good sleeper, but suddenly our bedtime routine is filled with battles. She gets scared when I leave the room. She clings to me and won't let me leave. During the night she wakes up and cries until I come to her. She's been clingy during the day, as well. Could she have separation anxiety?
It's very likely that separation anxiety is the culprit here, since this normal childhood condition peaks sometime between the first and third birthdays. Nearly all children experience separation anxiety at some point. Some have more intense reactions than others, and the stage lasts longer for some than others. For a number of children, this fear becomes a cause for new bedtime problems. In his book Sleeping Like a Baby (Yale University Press, 2001), Dr. Avi Sadeh, director of the Laboratory for Children's Sleep and Arousal Disorders, explains:
Separation anxiety is one of the main causes of sleep disorders in early childhood. The child often begins to resist sleep immediately at the start of the rituals that lead up to bedtime. Sometimes the source is a problem separating from parents. The refusal to lie down and go to sleep may express anxiety related to the coming separation, the need to continue the pleasurable connection with the parents, or anxieties related to nighttime, darkness, and being alone in the dark.
The development of separation anxiety demonstrates that your child has formed a healthy, loving attachment to you. It is a beautiful sign that your child associates pleasure, comfort, and security with your presence. It also indicates that your child is developing intellectually (in other words, she's smart!). She has learned that she can have an effect on her world when she makes her needs known, and she doesn't have to passively accept a situation that makes her uncomfortable. She doesn't know enough about the world yet to understand that when you leave her, you'll always come back. She also realizes that she is safest, happiest, and best cared for by you, so her reluctance to part makes perfect sense— especially when viewed from a survival standpoint. Let's put it another way: you are her source of nourishment, both physical and emotional; therefore, her attachment to you is her means of survival, and she realizes this when she reaches a certain level of intellectual maturity.
This stage, like so many others in childhood, will pass. In time, your child will learn that she can separate from you for the night, that you will return in the morning, and that everything will be OK between those two points in time. Much of this learning is based on trust, which, as for every human being young or old, takes time to build.
If you stop to think about it, usually the longest separation between you and your child is during her nighttime sleep when the two of you are apart for ten to twelve hours. During this time, your child will have a number of brief awakenings from sleep when she'll open her eyes and realize that she's all alone. This same thing happens every night, so when your child realizes that this long separation is about to occur, it may create struggles at bedtime.
Separation anxiety is pretty easy to spot, and you're probably reading this section because you've identified it in your child. The following are typical behaviors of a child with normal separation anxiety:
• Clinginess
• Refusal to go to sleep without a parent nearby
• Crying when a parent is out of sight
• Strong preference for only one parent, shown particularly at bedtime
• Fear of strangers or new situations
• Waking at night crying for a parent
• Being easily comforted in a parent's embrace
Children will naturally outgrow separation anxiety, but there are ways for you to support and encourage your child during the process. Many of these ideas will also speed along your child's emotional maturity when it comes to separation.
• Allow your child to be a child. It's perfectly OK—even wonderful—for your child to be so attached to you and for her to desire your constant companionship. Congratulations, Mommy or Daddy: it's evidence that the bond you've worked so hard to create is holding. So politely ignore those who tell you otherwise.
• Don't worry about spoiling him with your love or providing him the attention he needs as he's going to sleep or when he wakes up. The more that you meet his attachment needs at bedtime now, the more quickly he will outgrow his insecurities.
• Minimize separations when possible, especially at bedtime. It's perfectly acceptable for now—better, in fact—to avoid those situations that would have you separate from your child at his bedtime. All too soon, your child will move past this phase and on to the next developmental milestone. Most children outgrow the worst of separation anxiety by their third birthday, and for many it disappears by the time they turn five.
• Practice with quick, safe separations. Throughout the day, create situations of brief separation. When you are in the middle of your child's bedtime routine or just after she gets into bed, take brief trips to another room and whistle, sing, or talk to your child so she knows you're still there even though she can't see you.
• Don't sneak away when you have to leave her, whether it's for a brief jaunt to another room or to go to your own bed. It may seem easier than dealing with a tearful good-bye, but it will just cause her constant worry that you're going to disappear without warning at any given moment.
• Tell your child what to expect. If you are going out for the evening and leaving her at home with Grandma, explain where you are going and tell her when you'll be back. Don't expect her to go to sleep easily while you are away, and prepare Grandma so she'll know what to expect. One night of a late bedtime may be better than having Grandma deal with a crying child.
• Express a positive attitude when leaving him. If you're off to work or an evening out, leave with a smile. Your child will absorb your emotions, so if you're nervous about leaving him, he'll be nervous as well. Your confidence, on the other hand, will help alleviate his fears.
• Leave your child with familiar people. If you must leave your child, especially at bedtime, try to leave her with a familiar caregiver. If you must leave her with someone new, arrange a few visits when you'll all be together before you leave the two of them alone for the first time.
• Make sure that any caregiver who will put your child to bed knows her exact bedtime routine. Write it down so that the consistency of the nighttime ritual can be kept the same as usual. This will bring comfort and security and ward off anxiety.
• During the day, allow your child the separation that she initiates. If she goes off to play in another room, don't rush after her. Listen and peek, of course, to make sure that she's safe, but let her know it's fine for her to go off exploring on her own. These practice sessions will build her confidence in separations from you.
• Encourage her relationship with a special blanket, stuffed animal, or toy, if she seems to have one. These lovies can be a comfort to her at naptime and bedtime since they create a feeling of security.
• Don't take it personally if only one parent is accepted easily for the bedtime routine. Many children go through a stage of attaching themselves to one parent or the other, and it can be most pronounced when the child is tired. The other parent, as well as grandparents, siblings, and friends, can find this difficult to accept, but try to reassure them that it's just a temporary and normal phase of development, and with a little time and gentle patience it will pass.
• If you have an older toddler or preschooler with a vivid imagination, you can take advantage of this by adding a new step to her bedtime routine. Before you leave the room, give your child a "Little Mommy" or a "Little Daddy" to sleep with her. Simply cup your hands as if you are holding something and pretend to give her a tiny version of yourself. Ask her if you can have one of her to take to your own room. This Little Mommy idea can come in handy for daytime separations, too.