One page summary: Hearing loss after a birth injury

In two sentences

Hearing can be affected by several things around birth: very high bilirubin, meningitis, severe hypoxic-ischemic encephalopathy, prematurity, certain antibiotics, and infections during pregnancy. ¹

Every newborn in the United States is offered a hearing screen before leaving hospital. A pass is good news, and it does not rule out hearing loss that develops later. If your child is not responding to sound, ask for a full assessment even if the newborn screen passed. ²

The numbers, with their sources

• Screening. Newborn hearing screening is offered to essentially all babies born in the United States before hospital discharge ²
• The recommended timeline. Screening by 1 month of age, diagnosis by 3 months, and enrollment in early intervention by 6 months ²
• The commonest cause after birth injury. Very high bilirubin damages the hearing pathway in the brainstem, which is why kernicterus produces both a movement disorder and hearing loss ³
• A pattern that is missed. Auditory neuropathy, in which the inner ear works but the signal does not travel properly to the brain. Some screening methods can pass a child who has it ¹
• Late-onset loss. Some hearing loss appears after the newborn period, so a passed screen does not settle the question for life ²
• Cost estimate. CDC estimated lifetime costs associated with hearing loss at about $417,000 per person in 2003 dollars for those born in 2000 ⁴

What to do this week

1. Find out the newborn screen result and which method was used. Otoacoustic emissions alone can miss auditory neuropathy.
2. Ask where your child sits against 1 month, 3 months and 6 months.
3. If there was a refer result, make sure the follow-up appointment exists and has a date.
4. If there is any history of high bilirubin, ask for auditory neuropathy to be assessed specifically.
5. Refer to early intervention now, without waiting for a final diagnosis.
6. Start language exposure today, in whatever form is available.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the audiologist

• Which screening method was used, and was auditory brainstem response included?
• Is this sensorineural loss or auditory neuropathy?
• What is the degree of loss in each ear?
• What technology do you recommend, and when?
• When do we recheck, and what would prompt an earlier recheck?

For the pediatrician or ENT

• What caused this, and has cytomegalovirus been tested for?
• Should we do genetic testing?
• Is imaging of the inner ear indicated?

For the early intervention team

• Is there a teacher of the deaf on our team?
• What language access do you recommend right now, before devices are settled?
• How do we support language at home today?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Hearing loss after a birth injury

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.