Sara, a 23-year-old immigrant from El Salvador, said she spent the first 20 days in ICE detention begging for information about her 5-year-old daughter, who had been taken from her when they crossed into the U.S. from Mexico in 2016 seeking asylum.

When she was finally allowed a 15-minute phone call with her daughter, who was in the custody of the Office of Refugee Resettlement, the voice on the other end of the call had changed. Her normally ebullient child sounded shy and distant.

“She only answered ‘yes,’” Sara said. “I asked if there was food, she said ‘yes.’ I asked if she was OK, she said ‘yes.’ I told her we were going to be together again soon, and she just said ‘yes.’”

Sara and her daughter, whose real names VICE News is withholding because of their pending asylum case, spent two months separated in 2016 while Sara was in ICE custody.

The lasting trauma from the time Sara and her daughter spent apart is a glimpse into what’s ahead for more than 2,400 children who've been removed from their families by federal immigration authorities this year as a result of the Trump administration’s zero tolerance immigration policy. Under that policy, immigrants who cross the border outside of the designated entry points are criminally prosecuted, including asylum seekers with children.

But separations at the border were happening before the Trump administration’s “zero tolerance” policy was in place. Sara fled El Salvador in 2016 with her daughter, who was 5 years old at the time, to escape sexual violence from gang members in her home country, according to her lawyer, Ashley Harrington, managing attorney at the Rocky Mountain Immigrant Advocacy Network.

“When I decided to leave with my daughter, I thought we would be together”

“When I decided to leave with my daughter, I thought we would be together,” Sara said. “When I arrived and they separated us, it was so hard.”

Sara and her daughter were detained when they arrived at the Port Isabel, Texas, border crossing in April 2016. Federal immigration officials separated the two after finding a pending removal order for Sara, Harrington said.

“I told them you can’t do this,” Sara said. “They told me they would deport both of us right now. They took her away from me, and they didn’t tell me where she was going. They didn’t tell me anything.”

Sara didn’t see her daughter again for another two months. At the first facility where she was detained, she said, the officers were constantly yelling at her, and she had just one hour per day outside.

“That place was rough,” she said. “They treated us poorly. They got us up at 5 in the morning by screaming at us. We only had five minutes to shower or else we would lose breakfast privileges.”

She was transferred to another facility where she was treated much better, she said, and eventually she was able to make that call to her daughter.

Meanwhile, her daughter spent one month in an ORR facility before she was released to her grandparents in Colorado in May 2016. In total, mother and child were apart for two months, and even years later she is a very different child than she was before the separation, Sara said.

“She’s changed a lot. She only talks when people ask her questions”

“She’s changed a lot,” Sara said of her daughter. “Ever since I can remember, she’s been an outgoing girl, she talked a lot. Now she’s shy. She only talks when people ask her questions.”

Her daughter still gets very sad in the afternoons, a reminder of her time in federal custody. At the ORR facility, Sara said the kids were taken on field trips to Burger King or a park but had down time in the afternoon.

“She remembers being really sad in the afternoon because she couldn’t see anyone from her family,” Sara said.

All these changes sound like symptoms that Julie Linton, co-chair of the American Academy of Pediatrics Immigrant Health Special Interest Group, would expect to see in kids who’d been through the trauma of prolonged detention and separation from their parents.

“There’s this fight-or-flight response that people talk about all the time, that is designed for people to respond to an emergency,” Linton explained. “Your body is not designed to be in that state 24/7, for days on end. And so when that [happens], there is release of stress hormones, like cortisol, that can ultimately cause severe damage to the brain and the body.”

That level of stress, which Linton called “toxic stress,” can increase children’s risk for illnesses like depression, diabetes, and even heart disease.

As Sara and her daughter await a decision on their asylum claim, they are living with Sara’s father, who is her daughter’s official sponsor. Sara said she is working as a housekeeper at a hotel, and her daughter is on summer break from school.

But Sara and her daughter still face an uncertain future. Another Trump policy may affect Sara’s ability to stay in the U.S. long term. Earlier this month Attorney General Jeff Sessions ruled that domestic violence and gang violence no longer qualify as ground for granting asylum to immigrants who flee their home countries, like Sara.

“If I go back, they will kill me and my daughter,” she said.

Carter Sherman contributed reporting.

CORRECTION June 23, 2018, 3:43 p.m.: A prior version of this story reported that the child was six years old when she was separated from her mother in 2016. She was five.