Hearing loss is among the most common congenital anomalies, with every one to three per 1,000 children suffering from it. Hearing enables babies to learn a language and stimulates their brain development. That is why it is vital to conduct a hearing test for newborns to identify and address hearing problems as soon as possible. If an issue is not diagnosed or is left untreated, it may negatively impact the baby’s communication and language skills.

Why are hearing screenings important for newborns?
Newborns respond to sounds by startling, changing their movement, becoming quiet, or turning their heads toward the sound source. But this does not necessarily mean they can hear and respond to every sound or voice. Neonates with hearing issues may be able to hear some sounds, but their ears are not sensitive enough to understand spoken language. Therefore, getting a newborn hearing test as a part of a routine health check-up can help detect hearing loss in babies, if any.

Hearing tests enable parents and healthcare providers to monitor hearing changes during the early months of a baby’s life. Early detection of impairment can help parents and doctors develop a treatment plan and secure the child’s social and emotional development.

When to conduct the test?
Hearing loss in newborns is a major concern because it can eventually affect their academic achievement and social-emotional development. Hence, early detection of hearing loss is essential. A hearing test should ideally be done before the baby leaves the hospital after birth, preferably within two days. It can be performed as early as six hours after birth. In the case of healthy newborns, the baby can be taken home, and the test can be done within a month after birth. Weak or premature babies may undergo the test within three months of birth.

Types of newborn hearing tests
Hearing tests are important to evaluate the hearing status of babies. Newborn hearing screenings can be performed using two types of tests: otoacoustic emission (OAE) and auditory brainstem response (ABR). Both methods are safe, reliable, and painless. They can be used separately or in combination. Let us take a closer look at these tests:

Otoacoustic emissions tests (OAEs)
OAEs measure sound waves produced in the inner ear. A miniature earphone and microphone are placed just inside the baby’s ear canal, and the response (echo) to sounds like clicks or tones is measured. If a baby has a healthy ear, an echo is reflected into the ear canal, and the microphone measures that echo. In case of hearing issues, the OAE test detects no echo or reduced echo.

Auditory brainstem response (ABR)
ABR is another critical test to diagnose hearing loss in babies. It measures how well sound waves are conducted through the ear and passed to the midbrain. During this neonatal hearing screening, sounds are played to the baby’s ears, and band-aid-like electrodes are placed on the head to measure hearing sensitivity. The electrodes receive responses from the auditory nerve, and a computer measures these responses to identify if the baby has hearing loss.

Babies who fail to pass the first OAE test should be given a second screening using the OAE or ABR method. Newborns who were kept in the neonatal intensive care unit (NICU) for more than five days should undergo an ABR screening to detect the presence of auditory neuropathy.

Managing hearing loss in newborns
Early detection of hearing impairment in babies can help parents and doctors devise a treatment plan to help the infant develop normal language skills without delay. Treatments should commence as early as six months of age in infants born with hearing impairment.

Treatment for hearing loss in infants includes a range of doctor-recommended treatments and therapies, depending upon the baby’s overall health and the cause of hearing loss. Some therapies and treatments are speech therapy, learning sign language, and a cochlear implant. A cochlear implant is a tiny device inserted inside the baby’s ear to amplify sound. It can be used for babies as young as nine months.

Ear tubes (for repeated ear infections) and surgical procedures to correct structural problems are other methods that can be used separately or in combination with the therapies mentioned above.

With the advent of technology and the advancement in health sciences, experts have developed various treatments and hearing aids that help children acquire normal language skills at the same age as their peers. Even an infant with significant hearing impairment can lead a fulfilling life with the proper hearing tests and treatments for newborns.