Now Hear This: Newborn Screening Can Help Diagnose Hearing Problems

If you’re expecting a baby, you’re probably already thinking ahead about how to safeguard your child’s health. A slew of screenings administered within your baby’s first day of life can help alert you to many concerns. Did you know a hearing test is among them?

“Hearing loss is one of the most common congenital birth defects in America,” explains Jorge Perez, M.D., medical director of neonatal services at Baptist Health South Miami Hospital. “It is essential to identify hearing loss as early as possible because the most critical time for stimulating the hearing and language centers of the brain is during the first few months of life.”

Jorge Perez, M.D., medical director of neonatal services at Baptist Health South Miami Hospital

South Miami Hospital began implementing hearing tests for newborns long before they became required under Florida law in 2000. In fact, the hospital was one of five centers in a pilot study that convinced state lawmakers of the importance of adding such a screening, Dr. Perez says. “We knew that hearing problems were even more common than the other things we were testing for at the time.”

Approximately three in 1,000 babies are born with hearing deficits, according to the National Institutes of Health. Hearing problems are even more common in neonatal intensive care units, affecting approximately one in 100 babies.

What to Know About Newborn Screenings

Newborn Screening Awareness Month is observed every September to help parents understand these tests, the importance of following up and the difference that taking action can make in their child’s life.

The screenings aim to identify infants who may look healthy but have a condition that, left untreated, can result in a serious disability. These health issues should be treated as soon as possible to give children the best possible chance for healthy growth and development.

Florida law requires screening of newborns for more than 55 conditions including sickle cell anemia, cystic fibrosis, hypothyroidism and phenylketonuria. Most of these tests are conducted on a small blood sample taken from the baby’s heel. In addition, using different methods, babies are tested for congenital heart defects and how they process sound.

The screenings for hearing have had a huge impact on the lives of children, Dr. Perez says.

“Screenings can diagnose hearing issues at the earliest possible stage, when interventions can have the greatest positive impact,” he explains. “Prior to the introduction of newborn hearing screening programs in Florida, children with hearing deficits often we not diagnosed until they were three years old. Since the initiation of the newborn hearing screening, the average age of confirmation of hearing loss has decreased to two to three months of age.”

New Requirements

Dr. Perez and South Miami Hospital continue to advocate for babies, pushing for additional follow-up tests. A state law went into effect this year requiring babies who don’t pass the hearing screening to be tested for cytomegalovirus (CMV), which can cause permanent deafness and developmental challenges.

“We've been in the forefront from day one until now, basically in establishing not only policies and protocols, but also convincing our legislature to make it mandatory,” Dr. Perez says.

CMV infection is the most common infectious cause of childhood hearing impairment and accounts for 25 percent of deaf and hard-of-hearing children at age four, according to the American Academy of Pediatrics.

Although hearing loss can’t be reversed, a CMV diagnosis can help parents take proactive steps. “If a baby is CMV-positive, there’s treatment,” Dr. Perez says. “There are antiviral therapies that can improve the child’s prognosis.”

How It’s Done

Screening is not only about whether your child can hear, but how well. Testing may detect varying hearing levels that may affect your baby’s ability to learn.

Today, there are two types of screening tests for hearing, both of which use tiny earphones, special software and sensors to determine if baby’s hearing falls outside the typical range. The OAE (Otoacoustic Emissions) test uses a tiny device to measure the inner ear’s response to sound. Somewhat more advanced, the AABR (automated auditory brainstem response) test also looks at the auditory pathway to the brainstem.

“The AABR, which is the one that we use, is the gold standard,” Dr. Perez says. The technology has improved the prospects for deaf and hard-of-hearing children.

“We realized how important it was not to diagnose it early, but to intervene early,” Dr. Perez says. “If you don't intervene with either a hearing aid or a cochlear implant by six months of age, the child’s speech and language development may be very delayed. It's very time- sensitive.”

Dr. Perez expects newborn screening will continue to improve in the future.

“Honestly, technology keeps advancing,” he says. “Everything we do here is evidence-based and cutting-edge. We're always trying to see how we can improve what we're doing for our community.”