This article the hearing screen/test your baby will have after being born, why it is important and what happens if your baby does not pass this test.

• Most babies are born with normal hearing. But 1 to 3 out of every 1,000 babies are born with some hearing loss. Half of these children have no risk factors for hearing loss.

• It’s hard to tell if a baby has hearing loss without a newborn hearing screening.

• This screening can find hearing problems in the first few days of life.

  • If the screening shows a possible problem, more tests will be done to confirm the results.

  • If hearing loss is confirmed, it’s important to start treatment and early support as soon as possible. Your baby's primary care provider can help guide you to the right programs and services.

What is hearing loss?  

Hearing loss means not being able to hear sounds the way most people do.  

It can be:

• Mild, moderate, severe, or a complete loss of hearing

• Temporary or permanent

• In one ear or both ears

Hearing loss can make it hard for a child to hear sounds that are important for learning to speak.

It can happen because of a problem anywhere along the hearing pathway. This includes:

• Outer ear – blocked by too much wax or something in the ear canal

• Middle ear – from an infection or fluid build-up

• Inner ear (cochlea) – where sounds are turned into signals for the brain

• Hearing nerve – carries signals from the ear to the brain

• Hearing center in the brain – where the brain understands the sounds

Why do newborns need a hearing screening?

• Babies start learning from birth, and one important way they learn is through hearing.

• If a baby has hearing loss and doesn’t get the right help early, they may have trouble with speech and language development.

• Some babies may need early support, like using sign language or hearing aids.

• Studies show that babies who get treatment for hearing loss before 6 months old are more likely to develop strong language and learning skills.

• Some parents believe they would notice if their baby couldn’t hear—but that’s not always true. Babies may startle or turn their heads toward sounds, even if they don’t hear everything clearly.

• Most babies with hearing loss can hear some sounds, but not enough to learn how to speak clearly.

• Timing is important. Your baby has the best chance to develop normal language if hearing loss is found and treated before 6 months of age—and the earlier, the better.

How is a newborn hearing screening done?

There are 2 screening tests that may be used. Both tests are quick (about 5 to 10 minutes), painless, and may be done while your baby is sleeping or lying still. One or both tests may be used.

Automated Auditory Brainstem Response (AABR)	Otoacoustic Emissions (OAE)
This test measures how the hearing nerve responds to sound. Clicks or tones are played through soft earphones into the baby’s ears. Three electrodes placed on the baby's head measure the hearing nerve's response.	This test measures sound waves produced in the inner ear. A tiny probe is placed just inside the baby's ear canal. It measures the response (echo) when clicks or tones are played into the baby's ears.

Will my hospital automatically screen my newborn's hearing?

• Most hospitals do a hearing screening for all newborns. Some only screen newborns who are considered high risk, such as those with a family history of hearing loss.

• Most states have Early Hearing Detection and Intervention (EHDI) programs. These programs help make sure every newborn gets a hearing test and gets support if there is a problem.

• Be sure to find out the results of your baby's hearing screening before you leave the hospital. The hospital may also help you set up a follow-up test if needed.

What if my baby passes the hearing screening?

• If your baby passes the newborn hearing screening and has no risk factors, their primary care provider will keep checking their hearing and speech/language development during regular checkups. These checks are part of tracking your baby’s milestones

• Let your baby’s primary care provider know if you notice any problems with their hearing or how they communicate.

• If your baby has certain risk factors, the provider might order more hearing tests to make sure everything is going well. These risk factors may include:

  • Family history of hearing loss

  • Premature birth

  • Infections during pregnancy or after birth

  • Problems with the shape of the face or skull

What if my baby does not pass the hearing screening?

• If your baby does not pass the newborn hearing screening, it does not always mean they have hearing loss.

• Many babies who don’t pass still have normal hearing. But to be sure, your baby needs more testing which should include a more thorough hearing test and a medical evaluation.

• Further testing should happen as soon as possible, and definitely before your baby is 3 months old.

• Make sure to tell your baby’s primary care provider if they did not pass the hearing test in the hospital.

If hearing loss is found, what can be done?

• What happens next depends on the type of hearing loss your baby has.

• Every baby with hearing loss should see

  • A hearing specialist (audiologist) experienced in working with babies. They will do special tests to find out how much hearing loss there is.

  • A pediatric ear/nose/throat doctor (otolaryngologist)

  • A pediatric eye doctor (ophthalmologist) -  Some children with hearing loss can also have vision problems.

  • Genetic specialist - To check if the hearing loss is from a genetic or inherited reason.

• If your baby has permanent hearing loss, they may benefit from:  

  • Hearing aids  

  • Speech and language therapy

  • Sometimes, surgery.

• You will learn about different way to communicate with your baby, such as:

  • total communication

  • oral communication

  • cued speech

  • American Sign Language

    

• Your baby may qualify for free early intervention services through the Individuals with Disabilities Education Act (IDEA).

• Children who begin early support before 6 months of age often develop language skills similar to children with typical hearing.

Images from: CDC’s A Parent’s Guide to Hearing Loss  

What if I do not receive my baby's hearing screening results?

• You should receive the results of your baby's hearing screening before you leave the hospital.

• If you did not get the results of your baby's hearing screening, let your child’s primary care provider know and they may be able to obtain the results.

What if my baby did not receive hearing screening as a newborn?

• If your baby did not have a hearing screening done after birth, let your baby's doctor know so they can order the right test.

• Hearing can be tested at any age.

• If you ever have concerns about your baby’s hearing or speech development, talk with their doctor. Early testing and support can make a big difference.

This publication was adapted from information from American Academy of Pediatrics Patient Education materials.

Reviewed by: AM M.D., CPCMG Newborn Committee, AR D.O. | 06/2025  

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