Why does my child follow me to the bathroom?

Those who take care of children who are recovering from a tough start to life commonly report that the child in their care follows them to the bathroom, and becomes unreasonably distressed when prevented from doing so. In my experience this issue is not confined to the parent caregiver seeking to go to the bathroom. The child protests the parent caregiver speaking on the phone, intrudes into conversations with visitors, and becomes unreasonably distressed during any brief separation.

The child reacts to temporary separations and moments when their parent caregiver is not responding to them as if they will be forgotten about or abandoned.

In my opinion there are two intertwined factors at play here. One is what the child has learnt about the accessibility and responsiveness of adults in a caregiving role. The other has to do with cognitive development during the first year post-partum.

If we look at cognitive development first, one of the most influential developmental achievements during infancy is object permanency; that is, the capacity to hold a mental representation of an object when the child does not have sensory experience of it. Once an infant becomes aware of the existence of objects independent of their direct sensory experience them, the infant can tolerate the absence of the object from their sensory experience, because the foundations for their understanding that the object continues to exist is there. If we think of the parent caregiver as an object in the world of the infant, once they are capable of object permanency they are able to tolerate brief separations from the parent caregiver without fearing that the parent caregiver is lost or has abandoned them.

As to what infants learn about the accessibility and responsiveness of adults in a caregiving role, in a conventional nurturing care environment infants soon learn that their parent caregiver is available and responsive without them having to maintain parental attention to make it so. This learning is a product of the parent caregiver sensitively and consistently anticipating and responding to the infants cues regarding their needs. The infant soon learns that the parent caregiver can be relied upon for needs provision, without them having to maintain the parent caregiver’s attention to make it so.

When parents struggle to be consistently available and responsive to their infant, there are impacts to their learning and development. The child struggles to understand that their parent caregiver is really there for them when they do not have direct sensory experience of them. The child also learns that in order to increase their chances of needs provision they must keep their parent caregiver close by and under their direct influence.

So, how does a parent caregiver address these impacts to learning and development? In my opinion, the answer lies with how children understand the continuing existence of the parent caregiver independent of direct sensory experience of them, and learn to trust in their responsiveness.

Infants come to understand that their parent caregiver continues to exist and is accessible to them as a result of many temporary separations and reunions, where the parent caregiver consistently attends to the infant whether they were crying or quiet. Further, infants learn that their parent caregiver can be relied upon for needs provision when they anticipate and respond to the infants needs without the infant having to work hard to make it so.

We can support a child’s security about the continuing existence of the parent caregiver and new learning about their responsiveness by replicating the conditions under which this learning and development would normally occur in a conventional nurturing care environment. We can do this by reconnecting with the child after a temporary separation before the child does anything to make it so (i.e. attending to them whether they are crying or quiet), and addressing their needs proactively (i.e. without them having to do anything to make it so).

What we are trying to achieve are experiences that promote trust in the existence of an accessible and responsive parent caregiver. This contrasts with, and challenges, problems in learning and development that give rise to preoccupations with the accessibility and responsiveness of adults in a caregiving role.

Children and young people who accept the continuing existence of a sensitive and responsive parent caregiver have less difficulty believing in their worth and trusting in (reliable) others. The world is less overwhelming for them. Viewed in this way, proactive re-connection and needs provision support attachment security.

Some suggestions:

Where a child will not tolerate any separations at all, try using baby monitors or walkie talkies so that they still feel connected during temporary separations;
Engage liberally in peek-a-boo with the younger child, and games of hide-and-seek with the school-aged child. Progress to covering yourself with a whole blanket before revealing yourself when playing peek-a-boo.
Put a photo of you both and notes in the lunch-boxes of school-aged children.
Have a pre-prepared snack for the school-aged child and give it to them at reunion.