While most babies can hear normally, an estimated 3 out of every 1000 babies are born with some degree of hearing loss. Without screening or testing, however, hearing loss may not be detected until a baby is several months or even years older.
That’s why over 30 states, including New Jersey, have laws that require newborns have a hearing test before leaving the hospital or birthing center. This is a short, painless test called an auditory brainstem response (ABR). It uses a special computer to measure the way your baby's hearing nerve responds to different sounds. You’ll receive the results of this test before you take your baby home.
At Cooper, this test is performed by highly trained nurses and technicians. If an issue is found follow-up is with one of the audiologist in the Division of Otolaryngology (Ear, Nose, and Throat) – Head and Neck Surgery.
Why Choose Cooper to Treat Hearing Loss in Babies and Children
Cooper University Health Care’s Division of Otolaryngology – Head and Neck Surgery is part of the only tertiary-care, academic health system in South Jersey. We have a team of fellowship-trained otolaryngologists (ear, nose and throat specialists) as well as experienced audiologists, and licensed speech-language pathologists who are uniquely qualified to treat infants and children with hearing loss.
Together, they provide an unparalleled level of comprehensive medical and surgical care for the full range of issues relating to hearing loss in the smallest of patients.
Why It’s Important to Detect Hearing Loss Early
If hearing loss isn’t found until later, early stimulation of the hearing centers in your baby’s brain can’t take place. This can have a variety of negative impacts, including:
- Speech and language can be delayed
- Social and emotional development can be affected
- Success in school can be compromised
Importantly, many of these hearing loss complications can be prevented with diagnosis and appropriate treatment before your baby is 6 months old.
Risk Factors for Hearing Loss in Babies
Most hearing loss is present at birth (congenital), but some babies develop hearing loss after they’re born (acquired hearing loss). The major risk factors for hearing loss in babies are:
- Premature birth
- Low birth weight
- Long-term use of ventilators (breathing machines) in babies with respiratory problems
- Infections the mother passes to her baby in the womb (such as toxoplasmosis, measles, or herpes)
- Infections that can damage the brain after birth, such as meningitis or measles
Because of these risks, many health organizations, including the National Institutes of Health (NIH), the Joint Committee on Infant Hearing, the American Academy of Pediatrics, and the American Academy of Audiology now recommend universal infant hearing screening, which we perform here at Cooper.
Types of Hearing Loss in Babies and Children
There are two types of hearing loss that occur in babies and children:
- Sensorineural: This is due to a problem with the inner ear; it occurs when the tiny hair cells (nerve endings) that move sound through the ear are damaged. This type of hearing loss can be congenital (present at birth) or acquired (it develops after birth). Causes of sensorineural hearing loss include:
- Exposure to certain toxic chemicals or medicines while in the womb or after birth
- Genetic disorders
- Infections the mother passes to her baby in the womb
- Infections that can damage the brain after birth
- Problems with the structure of the inner ear
- Conductive: This is due to a problem in the outer or middle ear in which sound waves aren’t sent to the inner ear correctly. Conductive hearing loss is the most common type of hearing loss in children. This type of hearing loss can occur due to:
- Birth defects that cause changes in the structure of the ear canal or middle ear
- Buildup of ear wax
- Fluid behind the eardrum
- Injury to or perforation of the eardrum
- Foreign objects [LINK to Foreign Bodies in the Ear, Nose, and Airway page] stuck in the ear canal, such as beads or popcorn kernels
- Scar on the eardrum from repeated infections
Symptoms of Hearing Loss in Babies
Signs of hearing loss in infants vary by age. For example:
- A newborn baby with hearing loss may not startle (react) when there’s a loud noise nearby
- Older infants, who should respond to familiar voices, may show no reaction when spoken to
- Children should be using single words by 15 months, and simple two-word sentences by age 2; if they don’t reach these milestones, it may be due to hearing loss
Some children may not be diagnosed with hearing loss until they’re in school, even if they were born with hearing loss. Inattention and falling behind in class work may be signs of undiagnosed hearing loss.
How Hearing Loss in Babies and Children Is Diagnosed
Your doctor will use an instrument called an otoscope to look inside your child’s ear canal to view the eardrum and identify any structural or other visible problems that may cause hearing loss.
Two common tests are used to screen newborn infants for hearing loss:
- Auditory brainstem response (ABR) test: This test uses patches, called electrodes, to see how the auditory nerve reacts to sound
- Otoacoustic emissions (OAE) test: Microphones placed into the baby's ears detect nearby sounds. The sounds should echo in the ear canal; if there’s no echo, it is a sign of hearing loss.
Older babies and young children can be taught to respond to sounds through play. These tests, known as visual response audiometry and play audiometry, can better determine the child's range of hearing. Cooper's Audiology Department can conduct these tests.
How Hearing Loss in Babies and Children Is Treated
Treatment depends on your child's overall health and the cause of hearing loss. It may include:
- Speech therapy
- Learning sign language
- Cochlear implant (for those with profound sensorineural hearing loss)
- Medications for infections
- Ear tubes for repeated ear infections
- Surgery to correct structural problems
To learn more about the services available in the Division of Otolaryngology—Head and Neck Surgery or to schedule an appointment, please call 856.342.3113.