A New Mom’s Guide to Understanding Hearing Loss in Newborns

Getting news that your newborn has congenital hearing loss can feel overwhelming and confusing. Take a breath — with the right diagnosis, early intervention, and a supportive team, babies with hearing loss can grow up to be bright, social, and confident kids.

What Is Congenital Hearing Loss?

Congenital hearing loss means a baby is born with—or develops during pregnancy—a degree of hearing loss. It can affect one ear (unilateral) or both ears (bilateral), and that distinction matters for how we plan care and support.

Common Causes

• Genetic factors — about half of congenital cases have a genetic explanation. Examples include mutations like GJB2 (connexin 26) and SLC26A4 (pendrin).
• Infections during pregnancy — rubella, cytomegalovirus (CMV), and toxoplasmosis can affect fetal hearing development.
• Birth complications — prematurity, low birth weight, or oxygen deprivation at birth can contribute.
• Ototoxic exposure — certain medications and toxins can damage the inner ear.

Assessment & Diagnosis: The Tests You Should Know

A clear diagnosis is the first step to an effective plan. These are the main tests used with newborns and infants:

1. OAE (Otoacoustic Emissions)

OAE checks how the cochlea (inner ear) responds to sound. It’s quick, painless, and widely used for newborn screening.

2. ABR (Auditory Brainstem Response)

ABR measures electrical activity in the auditory nerve and brainstem in response to sounds. It's useful when OAE results are abnormal or when there’s a higher neurological risk.

3. ASSR (Auditory Steady-State Response)

ASSR gives frequency-specific estimates of hearing thresholds, which helps audiologists determine how much amplification a child needs at different pitches.

4. Tympanometry

This test assesses middle-ear function—useful for detecting fluid, infection, or eustachian tube issues.

Types of Hearing Loss

• Sensorineural — damage to the cochlea or auditory nerve (often permanent).
• Conductive — sound isn't transmitted efficiently to the inner ear (often treatable medically or surgically).
• Mixed — a combination of sensorineural and conductive factors.

How Severe Is It? (Simple Guide)

• Mild — soft sounds are hard to hear.
• Moderate — speech can be unclear without help.
• Severe — normal conversation is difficult to hear.
• Profound — very limited access to sound; often considered for cochlear implant.

Treatment & Intervention Options

1. Hearing Aids

For many children with sensorineural loss (mild to severe), hearing aids are the first step. Pediatric Behind-The-Ear (BTE) models are preferred because earmolds can be replaced as the child grows.

Key things parents should expect:

• Fitting and verification by a qualified hearing care professional using pediatric protocols.
• Regular earmold replacements (often every 2–4 months for infants).
• Ongoing aided testing to make sure the child actually has access to speech sounds.

Phonak Sky is one pediatric option designed specifically for kids, with durable builds, child-friendly colors, and features tuned for speech access.

2. Cochlear Implants

Cochlear implants are considered for children with bilateral severe-to-profound hearing loss who receive limited benefit from well-fit hearing aids. Outcomes are better with earlier implantation plus consistent post-op therapy.

3. FM / Remote Microphone Systems

These systems dramatically improve hearing in noisy environments like classrooms. The teacher wears a microphone; the child’s hearing device receives the signal directly, boosting the speech-to-noise ratio.

4. Speech Therapy & Early Intervention

Language therapy should start ASAP. Parents are the most important "therapists"—talking, reading, and labeling objects throughout the day are powerful ways to build language.

Developmental Milestones to Watch

Support at School

When it’s time for school, these supports help kids thrive:

• Sit near the teacher
• Use FM/remote mic systems
• Provide visual supports and clear notes
• Keep regular communication with teachers

Common Questions Parents Ask

Should my child start hearing aids right away?

For bilateral loss, earlier is generally better. Quick access to sound supports language development.

Are hearing aids safe for babies?

Yes—when fitted and verified by a qualified hearing care professional using pediatric protocols (safety limits are set and verified).

Will a cochlear implant make my child “normal”?

There’s no guarantee of “normal,” but many children make huge gains in hearing and speech with implants plus therapy. Early implantation and consistent follow-up give the best outcomes.