Stranger Anxiety
Author: Dr. Anna Kaplan
Babies go through many stages of social development, just as they go through phases of language development and motor development. Between 6 and 12 months of age, babies begin to show separation anxiety and stranger anxiety. While the word "anxiety" makes it sound like something is wrong, these are in fact normal stages of development.
Separation anxiety is fear of the parent leaving. Babies who seemed perfectly happy to stay with a sitter or grandparent may change dramatically during this time, and only want to be with parents or even one parent in particular. Leaving the baby with a sitter or in childcare can be much more upsetting for the baby and the parents.
Related to this is stranger anxiety. It means that your baby has learned the difference between people she knows, and people she does not know. It also means that she is bonding more strongly to you. Stranger anxiety may begin between 6 months and a year, usually around 8 to 9 months of age. With stranger anxiety, your baby may cry when approached by an unfamiliar person. This may happen at your baby's nine-month doctor visit. She may not want to see the doctor, and certainly will not want to be picked up and taken over to a table to be examined.
You need to know that this is a normal stage in development, and children outgrow it. Your child's doctor has seen it many times before; there is no reason for you to be embarrassed or think you are doing something wrong. Children vary significantly in how much stranger anxiety they have. But most have some. It is actually a sign that they are maturing psychologically.
Doctors who see children, pediatricians or family practitioners, will know how to help with this phase of your baby's development. They will probably not try and engage your baby directly. She will probably feel safest sitting in your lap, so you can hold her while you sit in a chair or on the examination table, depending on what furniture is available. You need to stay as calm as you can.
The doctor can talk to you about how the baby is doing, and any concerns you have, before he tries to examine her. A lot of pediatricians have toys around to help divert children. For example, many have small, fuzzy animals that are attached to their stethoscopes for babies to look at. Your doctor will do as much as he or she can to make your baby comfortable. If your baby has a comforting toy or blanket that helps her, bring it to the doctor's office and let her hold onto it.
The nine-month visit usually does not include vaccinations, unless your child is behind schedule. The chances are that nothing will actually happen to hurt or frighten her, beyond the fear of strangers. She may continue to have stranger anxiety up through about 18 months of age, and then it will start to go away. You will have more practice dealing with it.
While stranger anxiety and separation anxiety are not the same thing, they are very closely related. If she is getting used to being separated from you when a sitter or relative is taking care of her, for example, if you are working outside the home and have gone back to work, she will be making great improvements in this area. She will learn that you do come back eventually. She will probably bond more with other caregivers. The more she learns, the easier separation will be.
The same is true for stranger anxiety. As she gets used to more people, she will react less strongly. She may even grow to like the doctor, but probably not the nurse, who is the one to give the shots.
To sum it all up - most babies have some stranger anxiety which is the most prominent between around 8 months and 18 months of age. It has nothing to do with your parenting skills, or anything being wrong with the baby. Handle the situation as calmly as you can. Let her sit with you and help her to tolerate being examined. Your baby's doctor should be able to help you. He or she will not take it personally. They will, however, have a lot of experience dealing with it, and will have picked up their own best ways to make an anxious child feel safer.
