Newborn lying on back with a parent on each sideShare on Pinterest
Dmitry Borovikov/Stocks United

From the minute your baby is born, they’ll undergo a series of tests to check on their development and overall initial health. But don’t be alarmed. For the most part, these tests aren’t invasive and often include standard diagnostics such as logging your baby’s weight, checking for jaundice, and ensuring their little airways are clear.

Another important diagnostic is a hearing test. Usually completed shortly before your baby is discharged, hearing tests are vital to ensuring your baby’s developmentally on track.

If you give birth in a hospital or birthing center, you can expect your baby to get a hearing test before they’re discharged. Depending on the facility, your baby may undergo one of two common types of newborn hearing tests: automated auditory brainstem response or otoacoustic emissions.

Usually, the newborn hearing screening is a standard diagnostic that’s performed shortly after birth in medical facilities across the United States. In fact, in 2019, 97.7 percent of babies born in the United States had their hearing screened before reaching 1 month old.

These tests don’t pose a risk to your baby and won’t hurt them. Often the test is administered while your little one is snoozing. And in some cases, your baby may receive both tests. Each test takes no more than 5 to 10 minutes to complete.

Automated auditory brainstem response (AABR)

With the AABR test, technicians are measuring how your baby’s auditory nerve, the hearing nerve, and brain stem respond to sound.

Your baby will have small headphones placed on their ears and sticker-like electrodes placed on their head. Since babies can’t tell test administrators what they can or can’t hear, the electrodes measure the auditory nerve and brain stem response to gentle sounds like clicks or tones.

Otoacoustic emissions (OAE)

The OAE test focuses specifically on the ear’s functionality. In particular, the test measures the sound waves that are produced in your baby’s inner ear.

A small probe is placed just inside your baby’s ear canal. Similar to the AABR test, the sounds will include clicks and tones.

Newborn hearing screenings are powerful tools to identify potential hearing loss that could impact a child’s language development as they grow. But they’re also snapshots in time.

In other words, passing a newborn hearing test doesn’t mean your child will never experience hearing loss. And conversely, failing an initial hearing test doesn’t mean your child has permanent hearing loss.

To “pass” a test, your newborn must clear the screening in both ears. If your baby only passes in one ear, that test is considered “failed” and they’ll need to be rescreened. If your baby fails the first test but passes the rescreen and doesn’t have risk factors for hearing loss, this counts as a pass and they won’t need more screening.

Being able to hear is important — no parent wants to learn their bundle of joy didn’t pass a health screening. But just like with other diagnostic tools, it’s possible to have a false negative with newborn hearing tests.

According to Boys Town National Research Hospital, roughly 2 to 10 percent of all newborns in the United States won’t pass their first hearing screening. But of those who fail, less than 1 percent go on to be diagnosed with lasting hearing loss. So, what gives?

Common causes for a false negative test result tend to relate to the fact that your baby is a newborn. After spending 9 months in a fluid-filled environment, your baby may still have fluid in their middle ear. Also, the thick vernix coating that covers your baby’s skin when they’re born can sometimes get into the ear canal.

And in some cases, your baby might have been awake during the hearing test. It’s possible they were moving too much, crying, screaming, or fussing — which means the test results could be inaccurate.

Often, if your baby fails the first test, the hospital may perform the test again before both of you are discharged to verify if the initial test results were accurate.

While the standard is to test a baby’s hearing before they’re discharged from a hospital or birthing center, that doesn’t mean it always happens.

You should get your baby’s hearing checked before they reach 1 month of age. Typically, your baby’s healthcare professional can schedule the test. If your baby doesn’t pass this test, your pediatrician may recommend working with a pediatric audiologist.

Newborns in the neonatal intensive care unit (NICU) aren’t always screened within the first few days of life. Often this test may be delayed until they’re medically stable or ready to be discharged.

Additionally, parents who opt for at-home births will need to work with their doctor to schedule a hearing screening before their baby is 1 month old.

The push for early hearing screening is critical since babies learn by being immersed in the world around them. And being able to hear is an essential component for building speech skills.

Catching potential hearing loss early allows you to work with your baby’s care team on solutions. This makes it more likely your baby won’t fall behind developmentally.

Getting a passing screen in a follow-up exam can help ease your mind. Just remember that depending on your family history or any other underlying conditions that could impact your baby’s hearing, it doesn’t mean you no longer have to focus on potential hearing loss.

While AABR and OAE tests are considered the standard and most effective options for newborn hearing screenings, they’re not 100 percent perfect. It’s possible for some tones to be missed by the test. This would mean your baby could potentially have partial hearing loss.

And if you have a family history of hearing loss, your baby’s doctor or audiologist will generally recommend continued hearing monitoring. This is proactive — designed to prevent any hearing deficiencies from delaying your baby’s developmental journey.

Even if you don’t have any family history or known hearing concerns, your child should continue to have their hearing periodically checked.

If your baby has hearing loss, you’ll be referred to an audiologist and an ear, nose, and throat (ENT) doctor to determine how to manage their condition. Depending on the severity of your baby’s hearing loss, the doctor may recommend a variety of solutions. They may also provide you with recommendations for family support groups to help your family cope.

Hearing loss intervention in babies can include recommending a hearing device such as a pediatric hearing aid or cochlear implants. But as your child grows, there are other techniques to help them improve their language and communication skills.

In the United States, your child may learn American Sign Language (ASL). They may also learn skills such as lipreading or cued speech to help guide their communication. Alternatively, assistive listening devices such as personal FM amplifiers and closed captioning can also make understanding language in everyday life easier.

With all the tests your newborn will undergo in their first few days of life, the newborn hearing test is a critical one that shouldn’t be avoided. If your hospital or birthing center doesn’t perform the test before your baby is discharged (or you opt for a home birth), your healthcare professional can schedule the screening.

If your baby has hearing loss, take heart in knowing treatments are out there. You can work with a specialist to create a plan of action that best supports your baby’s language development.