Testing 1, 2, 3
You can't count on your baby's doctor to identify a problem -- most pediatricians don't have the proper equipment to do infant hearing tests in their offices.
Before you give birth, check with your hospital to make sure that hearing testing is part of their newborn screening process. If it's not, or if you give birth somewhere other than a hospital, ask your pediatrician to recommend a pediatric audiologist or otologist to screen your baby within her first three weeks. Hearing tests for newborns are mandatory in 42 states and in Washington, D.C. (although small hospitals may be exempt). "However, every baby's hearing should be tested at birth so that parents can get help quickly if there's a problem," says Simon C. Parisier, MD, cofounder of the Children's Hearing Institute, in New York City. Testing is especially crucial because research has shown that parents' impressions about their infant's hearing are often wrong. Even deaf babies can coo and make gurgling sounds. If you're not sure whether your baby has been tested, contact your hospital to check her records.
How It Works
A hearing test is easy and painless. Doctors use one of two measures: an otoacoustic emissions (OAE) test, which measures the response by the hair cells inside the ear when they're stimulated by sound, or an auditory brain-stem response (ABR) test, which measures brain-wave activity in response to sound. Both of these tests are given while the baby is asleep, and for babies, they're both pass-or-fail: They only tell doctors if a baby can hear 30 decibels (the sound of a whisper), which is the definition of normal hearing. If your baby fails the initial screening test, you need to make an appointment with an audiologist for more comprehensive testing in order to confirm the results, determine the severity of the loss, and get proper treatment.
"I wish I'd pushed the doctors to treat my baby's hearing loss sooner," says Heather Conar, of Nashville. Her son, Jacob, failed his hearing screening at birth, but he wasn't officially diagnosed with hearing loss and fitted for a hearing aid until he was more than a year old. "They thought the trouble was caused by fluid in his ears that would drain, but it turns out his hearing loss was permanent from the beginning," she says.
Doctors initially thought that Jacob had conductive hearing loss, which is caused by a blockage in the middle ear that makes sounds muffled. Babies who've had frequent ear infections can experience this type of mild, temporary loss due to fluid buildup in the ear. It can usually be corrected by putting tubes in the ears to drain the liquid. Sensorineural hearing loss, the kind that Jacob actually has, is more serious -- and usually permanent -- because it's caused by a problem with a child's auditory nerve. A child will need a hearing aid, which Jacob now has, or a cochlear implant (an electronic device that is surgically implanted behind the ear to stimulate the auditory nerve) in order to hear normally.
Even if your baby passes her infant screening test, it's important to continually pay attention to her behavior and reactions to sound, says Dr. Friedman. Hearing loss can be progressive or can occur as your child gets older. Risk factors for delayed-onset hearing loss include a family history of childhood hearing loss, recurring or persistent ear infections for at least three months, head trauma, and serious infections like bacterial meningitis. If you're ever concerned, take your child to get a hearing test.