What is the newborn hearing test for?

The newborn hearing test is a routine health check that will be offered to your baby soon after birth. The newborn hearing test is used to help detect hearing loss in babies. Your baby needs to hear to learn speech and language skills. If your baby has hearing loss from birth (congenital hearing loss) it’s important to diagnose this soon after birth. Early detection can help you and your health team take steps to improve your child’s language, as well as encourage their social and emotional development.

When does the hearing test happen?

The hearing test should ideally be performed before your baby leaves hospital after the birth. The test is usually done within 2 days and can be done as early as 6 hours after birth. If for some reason you go home before the test your baby can still have their hearing tested as an outpatient or during a home visit by an appropriately qualified early discharge nurse. The test should be done within 1 month of birth for healthy babies or by 3 months for sick or premature babies.

How is the hearing test done?

The hearing test is usually done at the bed side while you and your baby are still in hospital. The hearing screener will explain the test and ask you to sign a consent form.

Some Australian states use the automated auditory brainstem response (AABR) screening test. For this test, the screener places ear cups on your baby’s ears that play a soft clicking noise. Sensors are placed on your baby’s forehead, neck and shoulder to measure how the auditory nerve responds to the sounds played. The auditory nerve transfers sound from the cochlea in the inner ear to the brain. The test is quick and painless. Your baby can sleep or feed during the test.

Other states use a different screening test, known as the TEOAE (transient evoked otoacoustic emissions) hearing test. This test is done by placing a probe in the ear canal that makes soft sounds. This test is also quick and painless.

How long does it take to get the results?

The results of the test will be given to you immediately after the screen. Some babies will need to do a second test if the results of the first one are not clear.

What happens if there is a problem?

If your baby does not pass the hearing test the first time, the test will be done again. The repeat test is usually done 12 to 24 hours after the first test.

If your baby does not pass the second test, they will be referred for a diagnostic audiology assessment. This assessment is done by an audiologist (hearing specialist), ideally when your baby is 4 to 6 weeks of age so your baby can get support if hearing loss is diagnosed.

Will my baby need to be tested again when they are older?

If your baby passed the hearing test in both ears but has a risk factor for hearing loss (an above average chance of developing hearing loss), they may be referred to an audiologist for an assessment. If your baby has risk factors including significant head injury, a congenital disorder of the head or neck or an infection such as meningitis or encephalitis they should have an audiology assessment as soon as possible.

If your baby has other risk factors, an audiology assessment is recommended by 8 to 12 months of age. These risk factors include:

• family history of permanent childhood hearing loss
• health conditions known to be related to hearing loss
• being on a ventilator
• some types of antibiotic therapy
• severe jaundice
• infection during pregnancy, including rubella, CMV, herpes or syphilis

If your baby has passed the hearing test on both ears and does not have any risk factors for hearing loss, then your baby does not need to be tested again when they are older.

If you are concerned that your baby does not hear well, it is important to speak with your family doctor or your child’s paediatrician to arrange a hearing assessment.

How much does the hearing test cost?

The hearing test is free for all babies who are eligible for an Australian Medicare card.

Does my baby need to be tested?

As a general principle, all newborns should be tested for hearing loss. However, in some situations your doctor may advise delaying the test.

Your baby’s hearing test may be delayed if your baby is:

• born early (less than 34 weeks gestational age)
• medically unwell
• being treated for jaundice
• taking medicines that can affect their brain or ears
• on a ventilator
• in an incubator

In rare situations, your doctor may advise against performing the hearing test all together. For example, the test is not recommended for babies with obvious malformation of the face or ear.