You might be aware that a blood sample is taken soon after your infant is born to test for dozens of genetic and metabolic disorders. But did you realize that super quick (and painless) newborn hearing tests are also administered right around the same time?
While the vast majority of babies are born with perfectly fine hearing, the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend that a newborn hearing screening be part of the battery of tests that infants receive, ideally before they leave the hospital.
Here’s more about why a newborn hearing test is universally given, how it’s performed, and, if hearing difficulty or loss is detected, the available treatments for your baby.
What is the purpose of a newborn hearing screening?
The newborn hearing screening is designed to detect hearing abnormalities right after birth, since hearing loss is a common congenital condition among infants. In fact, roughly 2 or 3 out of every 1,000 babies in the U.S. is born deaf or hard of hearing, according to the National Institute on Deafness and Other Communication Disorders.
It’s vital that this test be done as soon as possible since babies start learning language from the get-go (long before they utter that first word). And hearing loss can also impact future literacy skills and social development. It’s especially important to follow up on a “failed test” (as some infants don't pass that first screening) so you can address her auditory issue quickly.
When should a newborn hearing screening be done?
Wondering when a screening for hearing should be done? This procedure should ideally occur at some point before your baby is discharged from the hospital and it takes all of five to 10 minutes to complete (the AAP’s goal is to have every infant tested by 1 month of age). A newborn hearing screening is flexible in nature, as it can take place in the delivery room, recovery suite or later on in the nursery.
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The infant hearing test is standard in the majority of U.S. states and some territories — and in states where the test isn’t mandatory, it’s either offered or you can request it. Find out where your state stands on this diagnostic by visiting Baby’s First Test. Because of how widespread this screening has become, more than 96 to 98 percent of babies now have their hearing tested within one month of birth.
If you find you live in a state where the test isn’t required by law, talk to your doctor to make sure that your baby gets a newborn hearing screening test before she leaves the hospital (these days, however, newborn hearing screening is the standard of care nationwide).
In terms of insurance coverage, 18 states require insurers to pay for the screening and at least four states have laws that note who will pay for the hearing test if insurance won’t cover it or the parents can’t afford it, according to the National Conference on State Legislatures.
How is a newborn hearing screen test done?
The accuracy of newborn hearing tests is well-established and they may be given two different ways. The following tests are fast, pain-free and can be done while your infant is asleep or resting quietly.
Otoacoustic Emissions (OAE). This test uses a tiny probe that’s inserted just at the entrance to your baby’s ear canal and emits a series of sounds. The test checks for echoes in your baby’s ears in response to the clicks or tones that are played. Babies whose ears do not have an echo could have hearing loss.
Automated Auditory Brainstem Response (AABR) or Auditory Brainstem Response (ABR). During this test, your newborn wears tiny earphones that play sounds and, along with three electrodes placed on her scalp, they’ll measure brain activity as she listens. A lack of brain activity could indicate a hearing problem.
What do the results of a newborn hearing test mean?
Keep in mind that a newborn who hasn't passed the initial hearing test may not necessarily have auditory loss. In fact, about 90 percent of newborn babies who don't pass the first screening go on to pass a subsequent hearing test. If your baby’s hearing screening comes back abnormal, the next step is typically a follow-up test and an appointment with a specialist, usually a pediatric audiologist, for a more comprehensive screen within the first three months.
In some cases, a baby may be diagnosed with temporarily impaired hearing caused by too much wax, vernix or fluid in the ear canals. Occasionally, there may be too much background noise during the first screening, which can also skew results so that the baby may need to be retested.
However, if it’s determined that your infant does have some hearing loss in one or both ears, it’s important for her to start treatment within the first six months of life — otherwise, she’ll miss a crucial window for learning how to talk. For infants who don’t pass the hearing screening test after a few tries, experts recommend that they have a full diagnostic evaluation at 3 months of age and get properly treated before they're 6 months old.
And while your baby may have passed the newborn hearing screening, it doesn’t mean she’ll never experience hearing loss later on in childhood. Some infants may develop hearing problems when they’re older due to genetics, frequent ear infections or other illnesses like measles or meningitis, or because they’ve been exposed to secondhand smoke, loud noises or a head injury.
How do you treat hearing loss in babies?
The best treatment for hearing loss in babies is an early intervention plan that includes your pediatrician, an audiologist and a pediatric otolaryngologist. This medical team can help you determine which treatments or devices can aid your baby best based on the type and degree of hearing loss she's experienced, such as hearing aids or cochlear implants (though the latter gets very mixed reviews in the deaf community).
With quick and consistent treatment, studies have shown that a baby’s spoken language development may match that of other babies her age if her hearing problems are discovered early and the intervention begins by 6 months of age or earlier if possible.
The newborn hearing test is a vital tool that can pinpoint an auditory loss quickly and efficiently. The AAP also recommends that kids be screened at ages 4, 5, 6, 8 and 10 — and anytime you suspect your child doesn’t hear well. Don’t skip these simple hearing tests since early action is the best defense for childhood hearing loss.
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