What can cause hearing loss in newborns

Hearing loss - infants: MedlinePlus Medical Encyclopedia

Hearing loss is not being able to hear sound in one or both ears. Infants may lose all of their hearing or just part of it.

Although it is not common, some infants may have some hearing loss at birth. Hearing loss can also develop in children who had normal hearing as infants.

• The loss can occur in one or both ears. It may be mild, moderate, severe, or profound. Profound hearing loss is what most people call deafness.
• Sometimes, hearing loss gets worse over time. Other times, it stays stable and does not get worse.

Risk factors for infant hearing loss include:

• Family history of hearing loss
• Low birth weight

Hearing loss may occur when there is a problem in the outer or middle ear. These problems may slow or prevent sound waves from passing through. They include:

• Birth defects that cause changes in the structure of the ear canal or middle ear
• Buildup of ear wax
• Buildup of fluid behind the eardrum
• Injury to or rupture of the eardrum
• Objects stuck in the ear canal
• Scar on the eardrum from many infections

Another type of hearing loss is due to a problem with the inner ear. It may occur when the tiny hair cells (nerve endings) that move sound through the ear are damaged. This type of hearing loss can be caused by:

• 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 (such as toxoplasmosis, measles, or herpes)
• Infections that can damage the brain after birth, such as meningitis or measles
• Problems with the structure of the inner ear
• Tumors

Central hearing loss results from damage to the auditory nerve itself, or the brain pathways that lead to the nerve. Central hearing loss is rare in infants and children.

Signs of hearing loss in infants vary by age. For example:

• A newborn baby with hearing loss may not startle when there is 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 2-word sentences by age 2. If they do not reach these milestones, the cause may be hearing loss.

Some children may not be diagnosed with hearing loss until they are in school. This is true even if they were born with hearing loss. Inattention and falling behind in class work may be signs of undiagnosed hearing loss.

Hearing loss makes a baby unable to hear sounds below a certain level. A baby with normal hearing will hear sounds below that level.

The health care provider will examine your child. The exam may show bone problems or signs of genetic changes that may cause hearing loss.

The provider will use an instrument called an otoscope to see inside the baby's ear canal. This allows the provider to see the eardrum and find problems that may cause hearing loss.

Two common tests are used to screen newborn infants for hearing loss:

• Auditory brain stem 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 is 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.

Over 30 states in the United States require newborn hearing screenings. Treating hearing loss early can allow many infants to develop normal language skills without delay. In infants born with hearing loss, treatments should start as early as age 6 months.

Treatment depends on the baby's overall health and the cause of hearing loss. Treatment may include:

• Speech therapy
• Learning sign language
• Cochlear implant (for those with profound sensorineural hearing loss)

Treating the cause of hearing loss may include:

• Medicines for infections
• Ear tubes for repeated ear infections
• Surgery to correct structural problems

It is often possible to treat hearing loss that is caused by problems in the middle ear with medicines or surgery. There is no cure for hearing loss caused by damage to the inner ear or nerves.

How well the baby does depends on the cause and severity of the hearing loss. Advances in hearing aids and other devices, as well as speech therapy allow many children to develop normal language skills at the same age as their peers with normal hearing. Even infants with profound hearing loss can do well with the right combination of treatments.

If the baby has a disorder that affects more than hearing, the outlook depends on what other symptoms and problems the baby has.

Contact your provider if your baby or young child displays signs of hearing loss, such as not reacting to loud noises, not making or mimicking noises, or not speaking at the expected age.

If your child has a cochlear implant, contact your provider right away if your child develops a fever, stiff neck, headache, or an ear infection.

It is not possible to prevent all cases of hearing loss in infants.

Women who are planning to become pregnant should make sure they are current on all vaccinations.

Pregnant women should check with their provider before taking any medicines. If you are pregnant, avoid activities that can expose your baby to dangerous infections, such as toxoplasmosis.

If you or your partner has a family history of hearing loss, you may want to get genetic counseling before becoming pregnant.

Deafness - infants; Hearing impairment - infants; Conductive hearing loss - infants; Sensorineural hearing loss - infants; Central hearing loss - infants

• Hearing test

Eggermont JJ. Early diagnosis and prevention of hearing loss. In: Eggermont JJ, ed. Hearing Loss. Philadelphia, PA: Elsevier; 2017:chap 8.

Haddad J, Dodhia SN, Spitzer JB. Hearing loss. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 655.

Vohr B. Hearing loss in the newborn infant. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 59.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What is Hearing Loss in Children?

Hearing Loss in Children

Hearing loss can affect a child’s ability to develop speech, language, and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential. If you think that a child might have hearing loss, ask the child’s doctor for a hearing screening as soon as possible. Don’t wait!

What is Hearing Loss?

A hearing loss can happen when any part of the ear is not working in the usual way. This includes the outer ear, middle ear, inner ear, hearing (acoustic) nerve, and auditory system.

Signs and Symptoms

The signs and symptoms of hearing loss are different for each child. If you think that your child might have hearing loss, ask the child’s doctor for a hearing screening as soon as possible. Don’t wait!

Even if a child has passed a hearing screening before, it is important to look out for the following signs.

Signs in Babies

• Does not startle at loud noises.
• Does not turn to the source of a sound after 6 months of age.
• Does not say single words, such as “dada” or “mama” by 1 year of age.
• Turns head when he or she sees you but not if you only call out his or her name. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.
• Seems to hear some sounds but not others.

Signs in Children

• Speech is delayed.
• Speech is not clear.
• Does not follow directions. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.
• Often says, “Huh?”
• Turns the TV volume up too high.

Babies and children should reach milestones in how they play, learn, communicate and act. A delay in any of these milestones could be a sign of hearing loss or other developmental problem. Visit our web page to see milestones that children should reach from 2 months to 5 years of age.

Screening and Diagnosis

Hearing screening can tell if a child might have hearing loss. Hearing screening is easy and is not painful. In fact, babies are often asleep while being screened. It takes a very short time — usually only a few minutes.

Babies

All babies should have a hearing screening no later than 1 month of age. Most babies have their hearing screened while still in the hospital. If a baby does not pass a hearing screening, it’s very important to get a full hearing test as soon as possible, but no later than 3 months of age.

Children

Children should have their hearing tested before they enter school or any time there is a concern about the child’s hearing. Children who do not pass the hearing screening need to get a full hearing test as soon as possible.

Learn more about screening and diagnosis »

Treatments and Intervention Services

No single treatment or intervention is the answer for every person or family. Good treatment plans will include close monitoring, follow-ups and any changes needed along the way. There are many different types of communication options for children with hearing loss and for their families. Some of these options include:

• Learning other ways to communicate, such as sign language
• Technology to help with communication, such as hearing aids and cochlear implants
• Medicine and surgery to correct some types of hearing loss
• Family support services

Learn more about treatments and intervention services »

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Causes and Risk Factors

Hearing loss can happen any time during life – from before birth to adulthood.

Following are some of the things that can increase the chance that a child will have hearing loss:

• A genetic cause: About 1 out of 2 cases of hearing loss in babies is due to genetic causes. Some babies with a genetic cause for their hearing loss might have family members who also have a hearing loss. About 1 out of 3 babies with genetic hearing loss have a “syndrome.” This means they have other conditions in addition to the hearing loss, such as Down syndrome or Usher syndrome. Learn more about the genetics of hearing loss »
• 1 out of 4 cases of hearing loss in babies is due to maternal infections during pregnancy, complications after birth, and head trauma. For example, the child:
  • Was exposed to infection, such as , before birth
  • Spent 5 days or more in a hospital neonatal intensive care unit (NICU) or had complications while in the NICU
  • Needed a special procedure like a blood transfusion to treat bad jaundice
  • Has head, face or ears shaped or formed in a different way than usual
  • Has a condition like a neurological disorder that may be associated with hearing loss
  • Had an infection around the brain and spinal cord called meningitis
  • Received a bad injury to the head that required a hospital stay

Prevention

Following are tips for parents to help prevent hearing loss in their children:

• Have a healthy pregnancy.
• Make sure your child gets all the regular childhood vaccines.
• Keep your child away from high noise levels, such as from very loud toys. Visit the National Institutes of Health’s website to learn more about preventing noise-induced hearing loss.

Get Help!

• If you think that your child might have hearing loss, ask the child’s doctor for a hearing screening as soon as possible. Don’t wait!
• If your child does not pass a hearing screening, ask the child’s doctor for a full hearing test as soon as possible.
• If your child has hearing loss, talk to the child’s doctor about treatment and intervention services.

Hearing loss can affect a child’s ability to develop speech, language, and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential. If you are a parent and you suspect your child has hearing loss, trust your instincts and speak with your child’s doctor.

Does your child hear?

According to statistics, every year in Russia, out of 1,000 healthy newborns, 1 child is born with total deafness. In children born prematurely, with low body weight, with CNS damage, this figure increases by 20 times. However, today, deafness is not a sentence. The main thing is to notice in time and turn to specialists.

Sometimes, walking down the street, we notice people who are gesticulating, turning towards each other. We pass by without thinking about how these people live in the country of the deaf when the world around you is devoid of all sounds, when you cannot hear the cry of a newborn baby, a declaration of love, words of forgiveness, pleas for help. And how does a little, just born man live in the world without a mother's lullaby, without dad's laughter, without a cat's meow, birds singing? How can he live and develop, deprived of hearing? And, if it seems to you that this trouble will bypass you and your loved ones, then I can upset you, this can happen to anyone. There are risk factors for hearing loss:

Adverse family history:

1. Hearing loss at a young age in at least one of the family members.

Adverse maternal history:

1. Toxicosis of the first half of pregnancy and preeclampsia.

2. Infectious and viral diseases of the mother during pregnancy (rubella, measles, herpes zoster, herpes zoster, cytomegalovirus infection, influenza, mumps, toxoplasmosis and other viral infections). nine0003

3. Maternal use of ototoxic drugs during pregnancy.

Unfavorable history of the child's life:

1. Prematurity.

2. Gestational age over 40 weeks.

3. Apgar score at birth 0-3.

4. Birth weight less than 1500 g

5. Neonatal asphyxia

6. Congenital malformations of the maxillofacial skeleton

7. Counted with hearing impairment of the malfunctions of the child

8. Intracranial birth injury

9. The gypoxic-ischemic lesion of the central nervous system

10. The hemolytic disease of the newborn.

11. Hyperbilirubinemia (more than 20 µmol/l).

12. Neonatal meningitis.

13. Treatment with ototoxic drugs

The main thing that every mother should know is that a newborn's hearing is checked at birth. home for 3-4 days. This is for ALL kids. The result must be recorded in the statement: it is: "test passed" or "failed". At this point, in more detail for those who "did not pass the test": dear mothers, it's too early to worry, this does not mean that the child does not hear, it means that you must repeat this test in 1 month at the clinic at the place of residence. There are reasons for not passing this test:

• Sulfur masses (birth lubrication) in the external auditory canal

• Myxoid tissue or exudate in the middle ear

• Damage to the external hair cells

• Test must be done in silence (the test must be performed in silence!)

If, for the second time, the child does not pass the audiological test, he must be sent for an in-depth audiological examination to the audiological center: for children of the Sverdlovsk Region - to the Regional Children's Audiological Center of the MKMC "Bonum". There, experienced specialists will determine the degree of hearing loss, tell your further actions. nine0003

Some babies need hearing aids and need to wear them at a certain time: up to 6 months. And it’s not true that everyone around will say that it’s too early, that you need to wait, that hearing aids spoil your hearing and you need to wear them only in extreme cases! You need to listen to the DOCTOR! After all, delay with hearing aid in the first year of life entails a lag in speech development. If the child does not hear sounds, he does not understand speech, so he will not start talking or will start talking later, with significant impairment. nine0003

Remember that today's hearing aids are not the outdated hearing aids you saw on your grandparents. Modern hearing aid is:

• Digital audio processing

• Setting accuracy

• Multichannel

• Programmability

• Multiprogramming

• Microphone directivity

• Acoustic management

• Acoustic Feedback Suppression

• Noise Cancellation

But, there is a hearing loss that no even the most powerful hearing aid can help: it's deafness! These are terrible words, they are scary to say to the doctor and scary to hear for mom: your child does not hear. And you understand that the best, most beautiful baby in the world will never become a musician (or a doctor, or an actor). Because he is deaf. Is it possible to convey all the grief and despair that covers parents, grandparents. The main thing is that you are not left alone at this moment. Doctors and teachers of the Regional Children's Audiological Center of the MKMC "Bonum" will help you cope with all the difficulties. nine0003

Today, deafness is not a sentence. There is a proven, effective and safe method for the rehabilitation of children with total deafness. This is a cochlear implant.

COCHLEAR IMPLANTATION is a system of measures and technical means aimed at restoring missing physical hearing.

Cochlear Implant Kit consists of two parts: internal and external. Internal (implantable), surgically placed under the scalp and into the cochlea during surgery. The outer part - the speech processor is worn behind the ear or fastened to the baby's clothes. nine0003

How does the cochlear implant system work?

1. The microphone picks up sounds around us and transmits them to the speech processor.

2. The speech processor analyzes sounds and encodes them into a sequence of electrical impulses.

3. The transmitter antenna sends these pulses through intact skin to the cochlear implant.

4. The implant transmits electrical impulses to electrodes in the cochlea, where the auditory nerve fibers are stimulated. nine0003

5. The auditory nerve receives electrical impulses and sends information to the auditory centers of the brain. The brain recognizes the transmitted signals as sound.

Indications for cochlear implantation