Newborn hearing screening

Overview

Newborn hearing screening is a simple, painless test that checks if a baby can hear properly. It is offered to all newborns in many countries, including the UK, usually within the first few weeks of life. The test can be done while your baby is sleeping and takes just a few minutes.

Permanent hearing loss is not common, but it can happen. About 1 to 2 babies per 1,000 are born with some degree of hearing loss. It is more common in babies with certain risk factors.

The screening is offered to all newborns. It is especially important for babies who have a family history of hearing loss, were born prematurely, or had an infection during pregnancy.

Symptoms

Common symptoms

• Not startling or waking at loud noises
• Not turning towards sounds by 3-4 months
• Not babbling or making speech-like sounds by 6 months

Symptoms in children

• Delayed speech or unclear speech
• Not responding when called
• Turning up the TV volume very high
• Trouble understanding in noisy places

Causes

Main causes

• Genetic factors (passed down from parents)
• Infections during pregnancy, such as rubella or cytomegalovirus (CMV)
• Problems at birth, like lack of oxygen or very low birth weight
• Certain medications given to the mother or baby that can affect hearing

Risk factors

• Family history of hearing loss
• Premature birth (before 37 weeks)
• Low birth weight
• Jaundice that needed a blood transfusion
• Infections like meningitis after birth

When to see a doctor

See a doctor urgently if:

• If the newborn hearing screening result shows a possible problem – you will be referred to an audiologist (hearing specialist) for more tests

Book a routine appointment if:

• If at any age you are worried about your child’s hearing, speech, or response to sounds
• If your child fails a routine hearing check at school

Diagnosis

Diagnosis begins with the newborn hearing screening, which uses two painless tests. If the screening suggests a problem, more detailed tests are done by an audiologist.

Tests that may be done

• Otoacoustic emissions (OAE) – a tiny earpiece plays sounds and measures echoes from the inner ear
• Automated auditory brainstem response (AABR) – small sensors on the baby’s head measure how the brain responds to sound

What to expect at your appointment

The tests are done while your baby is sleeping or quiet. They do not hurt. You can stay with your baby the whole time. Results are usually available right away.

Treatment

If hearing loss is found, early help is key. Treatment depends on the type and degree of hearing loss and may include hearing devices, therapy, and support for communication.

Self-care at home

• Learn about communication strategies like using visual cues, sign language, or spoken language
• Create a sound-rich environment at home – talk, sing, and read to your baby often
• Attend all follow-up appointments with the hearing team

Medical treatments

Options may include hearing aids (small devices worn in or behind the ear) or cochlear implants (a surgically placed device that helps the brain hear sound). Speech and language therapy is also often recommended. Your specialist team will explain what is best for your child.

When is surgery considered?

Surgery may be an option for certain types of hearing loss, such as cochlear implant surgery for severe to profound hearing loss. This is done by a specialist team and followed by therapy.

Living with this condition

With early support, most children with hearing loss develop good communication skills and do well in school and life. You will work with a team that includes audiologists, speech therapists, and teachers of the deaf.

Lifestyle tips

• Use visual cues when speaking, like pointing or showing
• Reduce background noise to help your child hear better
• Keep regular appointments with your hearing specialist
• Connect with other families of children with hearing loss

Diet and exercise

A healthy diet and regular exercise support overall development, but there is no special diet for hearing loss. Your doctor may recommend supplements if there are other health conditions.

Mental health and emotional wellbeing

It is normal to feel worried, sad, or overwhelmed when you learn your child has hearing loss. Talk to your healthcare provider and consider joining a support group. Your feelings matter and help is available.

Prevention

Some causes of hearing loss can be prevented, such as rubella infection during pregnancy (by getting vaccinated before pregnancy) and avoiding certain infections. However, many causes cannot be prevented, which is why newborn screening is so important.

Vaccines

The rubella vaccine (given as part of the MMR vaccine) before pregnancy can prevent one cause of congenital hearing loss.

Screening programmes

Newborn hearing screening is the standard way to identify hearing loss early. It does not prevent hearing loss but allows for early treatment and support.

Complications

If left untreated

• Delayed speech and language development
• Difficulty learning and doing well in school
• Social challenges and feeling isolated

Long-term outlook

When hearing loss is found early and support is given quickly, the outlook is very good. Most children with hearing loss can learn to communicate well and lead full, happy lives.

Find support

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