Could your baby have hearing loss? Here's what to know

Your baby is learning about the world from the moment they're born, and hearing plays a big role in everything from recognizing your voice to learning their first words. If your baby has hearing loss, catching it early can make a real difference. The sooner it's diagnosed and treated, the sooner your baby can get the support they need for speech, language, learning, and social development.

Most babies have their hearing screened shortly after birth. But hearing loss can develop later, too, so it's important to keep an eye out as your child grows. If you notice signs that your child isn't hearing well, or you have any concerns about their hearing, talk to their healthcare provider as soon as possible.

What is hearing loss in babies?

Hearing loss is one of the most common conditions identified at birth. Although most babies are born with typical hearing, about 1 to 3 of every 1,000 babies in the United States are born with hearing loss. Babies who spend time in the neonatal intensive care unit (NICU) have an even high risk of hearing loss.

Babies with hearing loss can have different levels of hearing. Some may hear many sounds but have trouble catching the softer, quieter parts of speech. Others may have trouble hearing even loud or shouted speech without the support from devices like hearing aids or cochlear implants.

If you learn your child has hearing loss, your audiologist will discuss what type of hearing loss your baby has, how severe it is, and how to get started with the right devices so your baby can hear. 

You'll want to start early intervention as soon as you can. It's best for children with hearing loss to receive support as early as possible – ideally before they're 6 months old. The sooner a hearing problem is diagnosed and treated, the more likely it is that your child will meet developmental milestones.

What are signs of hearing loss in babies?

Every baby is unique, and signs of hearing loss can look different for each child. Don't let one item on the list cause you to panic. Some of these signs may not be applicable to your child, or another reason could be the cause. (For example, your baby may be a very sound sleeper and not wake to voices, or they may have colic and won't soothe no matter what.) 

But talk to your baby's doctor if you notice any of these red flags:

Warning signs: Newborn to 3 months

• Doesn't startle in response to a sudden loud sound
• Doesn't respond to sounds, music, or voices
• Isn't soothed by soft sounds
• Doesn't move or wake up at the sound of voices or nearby noises when sleeping in a quiet room
• By 2 months, doesn't make vowel sounds like "ohh"
• By 2 months, doesn't become quiet at the sound of familiar voices

Warning signs: 4 to 8 months

• Doesn't turn their head or eyes toward a sound they can't see
• Doesn't change expressions at the sound of a voice or a loud noise when they're in a quiet setting
• Doesn't seem to enjoy shaking a rattle, ringing bells, or squeezing noisemakers
• By 6 months, doesn't try to imitate sounds
• Hasn't begun to babble to themself or back at others who speak to them
• Doesn't respond to "no" and changes in tone of voice
• Seems to hear some sounds but not others
• Seems to pay attention to vibrating noises (those that can be felt) but not those that are only heard

Warning signs: 9 to 12 months

• Doesn't turn quickly or directly toward a soft noisemaker or "shush"
• Doesn't respond to their name
• Doesn't vary their pitch when babbling
• Doesn't make several different consonant sounds when babbling (m, p, b, g, etc.)
• Doesn't respond to music by listening, bouncing, or singing along
• At 1 year, doesn't say single words, like "dada" and "mama"
• Doesn't understand words for common items (like "shoe"), expressions (like "bye-bye"), or commands (like "come here")

The American Speech-Language-Hearing Association (ASHA) offers more information about developmental milestones related to listening and talking, and how to find a professional to work with if you're concerned.

Wondering what's next? Download the free BabyCenter app to track milestones and get expert-backed guidance tailored to your baby's age.

What causes hearing loss?

Ninety-four percent of babies born with hearing loss are born to two hearing parents who have no known hearing loss in their family. Some of the known causes of hearing loss include:

Genetics. A genetic hearing loss is caused by changes in the genes a baby inherits from their parents – even if both parents are hearing. This type of hearing loss is also sometimes called hereditary.

Infections during pregnancy. Some infections during pregnancy, including cytomegalovirus (CMV), rubella, toxoplasmosis, and herpes simplex virus (HSV), can affect a baby's developing hearing and may cause hearing loss.

Premature birth or low birth weight. Babies who are born early or don't weigh enough at birth are at increased risk for hearing loss, especially if they experience medical complications that can lead to hearing loss, like the need for ototoxic medications, hyperbilirubinemia, or anoxia.

Differences in ear development. Sometimes the outer, middle, or inner ear develops differently before birth, which can affect hearing and lead to hearing loss.

Illness or injury. Sometimes hearing loss develops after birth because of a serious illness, infection (such as meningitis), or an injury that affects the hearing system.

Certain medications. Some medications used to treat serious illnesses, including certain intravenous antibiotics (such as aminoglycosides), chemotherapy drugs, and some diuretics, can affect hearing and may cause hearing loss.

Recurrent ear infections. If your baby has recurring ear infections or middle ear fluid, your baby's doctor will likely recommend a hearing test. (If they don't, you can ask for one.) Your doctor may also recommend inserting tubes into your baby's eardrums so that any fluid that accumulates behind them will be able to drain.

Earwax and foreign objects in the ear can also cause temporary hearing loss.

What are the different types of hearing loss?

If your baby is born with hearing loss, this is known as congenital hearing loss. Acquired hearing loss is when a baby loses their hearing after they are born. 

The most common types of hearing loss are:

Conductive hearing loss

When problems in the outer or middle ear – such as an ear infection, wax buildup, or a problem with how the ear is formed – cause issues with hearing, this is known as conductive hearing loss. This type of hearing loss may be corrected with medical treatment or surgery.

Sensorineural hearing loss

When there is a problem in the inner ear or cochlea, this is known as sensorineural hearing loss. The hearing loss is permanent, and it can't be corrected with surgery. With hearing aids or cochlear implants, listening and talking are still possible. 

Mixed hearing loss

Some babies have both conductive and sensorineural hearing loss.

How are hearing problems in babies diagnosed?

Most hospitals screen a new baby's hearing before sending them home, which typically takes only five to 10 minutes. If your baby wasn't screened in the hospital, ask your baby's pediatrician about checking their hearing as soon as possible – within the first month.

Sometimes hearing loss develops later on. Parents and caregivers are often the first to notice when a baby isn't hearing well, so if you notice that your baby isn't reacting to sounds as you think they should, tell your doctor right away.

If it seems your baby may have hearing loss, you'll likely be referred to a pediatric audiologist. This specialist is an expert in childhood hearing and will perform a comprehensive evaluation. Try to schedule this appointment as quickly as possible. It's important to know the status of your baby's hearing and learn ways to help them start listening and talking.

Your child's doctor can refer you to a pediatric audiologist, or you can search for one at the American Academy of Audiology's website.

How are hearing problems treated?

If your child is Deaf or hard of hearing, there are many options for helping them hear as much as possible.

Treatment possibilities include:

Hearing aids. Typically, the first devices for babies with hearing loss will be hearing aids, which can even be fitted on newborns during the first few days and weeks of life. Hearing aids amplify sounds, making them louder, and are customized just for your baby. 

For many infants and young children, hearing aids can provide the access they need to hear all of the sounds of speech, which leads to developing listening and spoken language skills, reading, school success, and more.

Cochlear implants. These hearing devices provide the brain with access to sound by bypassing the ears. One part of the device is implanted through a surgical procedure. This may sound like a lot for a baby, but rest assured, it's safe – cochlear implants are approved for babies as young as 7 months old. 

There are specific guidelines your pediatric audiologist and pediatrician will share with you if a cochlear implant is recommended.

Bone conduction devices. These devices may be recommended for children with conductive hearing loss. They are placed on the bone located just behind the ear, called the mastoid bone, and held in place with a headband. The sound travels through the bone to the auditory nerve and then to the brain so that your baby can hear.

Ear tubes. These are tiny tubes placed through the eardrum to prevent fluid buildup. They're often used for children whose hearing loss is due to frequent ear infections. 

Medicines or surgery. An ear doctor will evaluate your child's hearing and determine whether a medical treatment, such as medicine or surgery, may be helpful for your child. Surgery can sometimes correct structural problems in the outer and middle ears.

Listening and spoken language (LSL) intervention. LSL intervention is a research-backed approach to help children who are Deaf or hard of hearing learn to talk, using hearing technology and everyday interactions like talking, reading, and singing together. 

Working with an early interventionist, you'll attend sessions with your child as you learn how to support your baby in developing strong listening and talking skills. With early diagnosis, properly fit hearing devices, and support from a trained professional team, kids following the LSL path learn to listen, talk, and read just like kids with typical hearing. 

Sign language. Sign language is a complete language with its own grammar and sentence structure that's different from spoken English. Instead of spoken words, it uses hand movements, facial expressions, and body language to communicate. 

If you choose sign language as your child's primary language, they'll need regular, everyday exposure to fluent signers to learn it. And if you and your family don't already know sign language, you'll need to learn it, too, so you can communicate with your child and support their language development.

What can I do to help prevent hearing loss in my baby?

While a baby will sometimes have hearing loss because of genetics or an unavoidable condition, there are things you can do to minimize the risk from other factors.

Before and during pregnancy

Get regular checkups. A preconception checkup helps make sure you're healthy before getting pregnant. During your pregnancy, get regular prenatal care so any problems can be detected and treated early.

Protect yourself from infections. Make sure your vaccinations are up to date, so you're not susceptible to preventable diseases. Get checked for sexually transmitted infections before pregnancy, and practice safe sex. Wash your hands regularly.

After your baby is born

Never insert anything into your baby's ear canal. Even cotton-tipped swabs can cause damage.

Keep your baby up to date on recommended vaccinations. Vaccines help protect against infections such as meningitis, measles, and mumps, which can sometimes cause hearing loss.

Monitor your baby's colds and ear infections. If your baby shows signs of an ear infection, talk with your doctor.

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