Most babies are born with normal hearing and experience the beauty of sound from the beginning —but 1-3 out of 1000 are born with hearing loss. Those children cannot properly hear their parents speak, sing or read to them which delays speech and language learning. Newborn hearing screening identifies babies at risk for hearing loss so they can be evaluated and treated early.

The hearing screening is performed in the hospital by a nurse or outside of the hospital by a health professional. Many countries have implemented Universal Newborn Hearing Screening so that every baby has access to hearing screening soon after birth.

When a baby does not Pass the hearing screening it means that more testing is needed. The baby could have hearing loss and it is important to follow-up.
It does not mean that your baby definitely has permanent hearing loss. Temporary conditions can affect the result even for a baby with normal hearing. These conditions include:

• The ear canal was blocked with fluid or vernix (white coating on the skin) which clears in a few days.
• The baby was too active or awake during the screening.
• There was interference in the test room such as background noise or electrical interference.

Screeners try to control the test conditions to get a reliable test. Waiting to screen until the baby is at least 12 hours old can avoid issues with fluid in the ear canal. It is best to screen when the baby is sleeping quietly after being fed. Also screeners should try to find a quiet room for testing.
When a baby does not pass the first screening, many Newborn Hearing Screening programs will perform a second screening before sending the baby on for more in depth testing.

If a newborn fails a hearing screening repeatedly, follow-up evaluations should be performed. Diagnostic tests are usually performed by audiologists or ENT doctors in the community.

The evaluation will confirm if hearing loss is present and determine the type and severity of the hearing loss. The baby may also be referred for further medical evaluations if a hearing loss is confirmed. Understanding the cause, type and severity of the hearing loss is important for defining a treatment plan. For a baby with permanent hearing loss, some intervention options include hearing aids, cochlear implants or early intervention (educational support, speech & language therapy, communication methods).