Although your baby's ears are fully developed at birth, understanding and analyzing sounds takes time. However, you will continue to sing bedtime songs to your baby from the moment he is born until the day he can understand you well. So, in my Dalili Medical guide, we explore more information about infant hearing in this article, such as: When does a newborn start hearing sounds? When does he pay attention to his name? How can I know if my baby is not hearing? Do babies who are not hearing tend to babble? How can I test my newborn's hearing? What are the methods available to test hearing in children at home? And other important topics.

Does a baby with hearing loss cry?

 

Yes, if the baby has a mild hearing loss, he will still be able to hear most or all of the sounds made when he cries or babbling.

Does a baby with hearing loss make sounds?

 

Scientists confirm that babbling or making sounds is a healthy sign of hearing integrity in newborns. Babbling increases as babies develop their ability to hear speech and try to imitate sounds. Babies who have trouble hearing will have less ability to babble.

What is a comprehensive newborn hearing screening?

 

A newborn hearing screening is performed shortly after birth, usually during the first month. It measures otoacoustic emissions (OAE). This test is painless and does not cause any discomfort to the baby, and usually takes five to eight minutes.

Note: If your baby does not pass the hearing screening or shows signs of hearing loss or impairment, he or she will undergo another assessment called an ABR, which is a similar test in terms of time and procedure, and measures the physiological response of the brainstem to sound.

**Detecting Hearing Loss in Your Baby**

Earwax is a substance that the body naturally produces to protect the ear from bacteria and infections. Without wax, the ear becomes dry and more prone to itching and infection. Despite its importance, a buildup of earwax can cause health problems. After birth, you may notice signs of hearing loss while you are cuddling your baby, or it may be diagnosed later. The most important thing is that the child suffers from symptoms of hearing loss and needs to treat neural hearing loss as soon as possible, so that he can play and learn like other children his age.

**Table of stages of hearing development in infants**

In this table, we review the stages of hearing development in newborns:

**Development of the child's hearing from birth to two months of age:** At this stage, the infant can hear loud and noisy sounds clearly, while he may not respond to other sounds.

**Development of infant hearing at 3 months of age:** By this age, your child is expected to show reactions to sounds, such as trying to imitate the sounds heard. You may notice that your child begins to babbling when he hears your voice or other sounds. This process is very important, as it helps the child develop his speech skills through imitation.

**Development of hearing in a child at 6 months of age:** At this stage, the child's imitation of sounds increases significantly, as he becomes able to listen to sounds more accurately and respond to them better. The child can also begin to recognize his name at this stage.

**Hearing development in a one-year-old child:** Finally, your child is able to recognize all sounds, including favorite songs and cartoon characters' voices.

### Causes of hearing loss

#### Low birth weight Hearing loss can occur in one or both ears, and may range from mild to moderate to severe to profound. Profound hearing loss is what is commonly known as deafness, but in some cases, hearing loss may worsen over time, while in other cases it remains stable without deterioration. Factors and causes that increase the risk of hearing loss in infants include the following:

- Having a family history of hearing loss.

- Low birth weight.

- Problems with the outer or middle ear.

- Congenital defects affecting the structure of the ear canal or middle ear.

- Accumulation of earwax.

- Accumulation of fluid behind the eardrum.

- Injury or rupture of the eardrum.

- Presence of foreign bodies in the ear canal.

- Scars on the eardrum resulting from repeated infections.

#### Central hearing loss Another type of hearing loss in children is caused by problems in the inner ear. This happens when the tiny hair cells, which act as nerve endings to transmit sound, are damaged. This type of hearing loss can be caused by:

- Exposure to toxic chemicals or medications during pregnancy or after birth.

Genetic disorders.

Infections that are passed from mother to fetus during pregnancy, such as toxoplasmosis from handling cats, measles, or herpes.

Infections that may affect the brain after birth, such as meningitis or measles.

Problems with the structure of the inner ear.

Tumors.

Damage to the auditory nerve or the nerve pathways in the brain that lead to the nerve, but central hearing loss is rare in infants and children.

**How ​​to check if a newborn can hear**

 

There are several common ways to assess hearing in newborns, including:

1. **Otoacoustic emissions (OAE)**: This test measures the inner ear's response to sounds, and can detect even mild hearing problems.

2. **Auditory Brainstem Response (ABR)**: This test measures the brain’s response to sounds and can identify hearing problems even in newborns.

**How ​​is a newborn hearing test performed?**

 

A newborn hearing test is a simple, painless procedure that usually takes less than 30 minutes. During the test, earphones or small probes are placed in your baby’s ears, and the health care provider monitors your baby’s responses to different sounds.

**Grades of hearing loss in infants**

1. **Mild hearing loss**: In this case, the child cannot hear sounds with a frequency of less than 26 decibels with his better ear. However, he can hear normal sounds within a meter radius and then repeat them.

2. **Moderate hearing loss**: Here, the child cannot hear sounds with a frequency of less than 41 decibels with his better ear. However, he can hear loud sounds within a meter radius and then repeat them.

3. **Profound hearing loss**: In this case, the child cannot hear sounds with a frequency of less than 61 decibels. He can only hear you if you speak very loudly and close to his better ear.

4. **Profound hearing loss**: In this case, the child cannot hear sounds with a frequency of less than 81 decibels, and sometimes more. Therefore, he cannot hear or understand any sound, no matter how loud it is, whether you are close to his ear or far away. The second, third and fourth degrees are considered hearing disabilities, and require rapid intervention. Newborns are often screened in most countries of the world for early detection of hearing problems.

**The importance of screening**

Newborn hearing screening is one of the basic and important steps in determining whether a child is deaf or hard of hearing. Infants with hearing problems need appropriate support, care and early intervention services to promote their healthy development. If the hearing condition is not detected, it may negatively affect the child's communication and language skills. In the long term, hearing loss can also affect the child's academic achievement and social and emotional development.

What are the signs that indicate that your child may have a hearing loss?

 

- Continuing to sleep despite loud noises.

- Delayed speech compared to peers of the same age.

- Not paying attention to the source of sounds, especially soft sounds.

- The child does not respond to the talk of people around him, especially if they are far away from him.

- The child noticeably raises the volume of the TV.

- Decreased academic achievement.

- Pronouncing some letters incorrectly.

What does it mean if your child fails the hearing test?

 

When a negative result is obtained in the hearing test, the child is referred to the appropriate entity for additional tests. A comprehensive medical and hearing assessment is performed by referring the child to a pediatrician, an audiologist, and an otolaryngologist. Based on the results, the necessary intervention process begins.

**Warning:** Failure to pass the hearing test at birth does not necessarily mean that the child has hearing loss. Fluid in the ear often affects hearing ability. There are many children who do not pass the newborn screening but do not have any hearing problems.

**What should we do if the test shows a problem with your child’s hearing?

 

The family, the child’s doctor, and the audiologist should work together to determine the extent of the problem and appropriate treatment methods. In addition to early medical or surgical treatment for hearing loss, parents need to monitor the child’s progress and facilitate the use of hearing aids, in addition to therapeutic exercises that aim to help the child become an aware listener and speaker. The strong desire of the parents to support the child and monitor his development throughout his life is the common factor among successful children with hearing loss.

If my child passes the newborn hearing test, does that mean he will not have hearing problems later?

 

Unfortunately, the answer is no. Some children may develop hearing loss later in childhood. The causes can be genetic, or the result of repeated ear infections, head injuries, meningitis, or exposure to high levels of noise. Therefore, parents are always advised to have regular hearing tests (at birth, 6 months, 1 year, and 2 years), especially if there are signs of hearing loss, such as:

A family member who has been deaf or hard of hearing since birth, or who lost hearing in early childhood.

The mother had an infection during pregnancy, such as rubella.

Your child suffered from jaundice at birth.

Your child suffered from a serious illness or infection, such as meningitis, which required oxygen or admission to the intensive care unit.

Your child suffered from recurrent ear infections.

Your child suffered a head injury.

The child had congenital abnormalities indicating the presence of genetic diseases.

The child weighed less than 1500 grams at birth.

You were concerned about your child's delayed academic progress compared to his peers of the same age.

When does a newborn start hearing sounds?

 

Newborns can hear sounds from the fourth month of pregnancy. When they are born, they are used to the sounds they heard in the womb, such as their mother's voice and heartbeat. However, it is important to have a formal hearing test to make sure there are no health problems.

Signs that your baby's hearing may be problematic:

**From birth to three months:**

- The baby does not show a reaction such as surprise or fear when hearing loud sounds.

- Does not respond to sounds around him.

- Does not wake up or move when hearing loud sounds.

- Does not calm down when hearing familiar sounds, such as his mother's voice.

**From four to eight months:**

- Does not move his head or eyes towards the source of sounds.

- Does not show any expressions when hearing loud sounds near him.

- Does not react to toys that make sounds.

- Does not try to imitate the sounds he hears, even after reaching six months.

- Does not respond to his parents when their usual tone of voice changes.

- He may hear some sounds but not others, as some children may react to sounds accompanied by vibration, because they feel them but do not hear anything else.

Month 9 – Month 12

- Does not respond to attempts to calm him down or to the sounds around him.

- Does not react when called by his name.

- Shows no response to music.

- Does not utter any intelligible words.

- Does not understand wordsThe usual or repetitive sounds that you use constantly.

- Makes unfamiliar sounds that do not resemble the sounds of natural letters

**Signs of hearing loss in newborns**

Signs of hearing loss in newborns include the following:

1. **Not paying attention to sounds**: If the child does not pay attention to sounds after reaching 6 months, this may be evidence of hearing loss.

2. **Not directing your gaze when called**: If your child does not look at you when you call him, but waits until he sees you coming, it may be difficult for you to notice that there is a problem, so you should make sure that he can hear by calling him by your name and watching his reaction.

3. **Not being fascinated by loud sounds**: If the child does not show any reaction to loud sounds, although newborns are usually attracted to them, this may be an indication of a problem.

4. **Not saying words**: If your child is one year old and does not say simple words such as "mama" or "baba", this may indicate a hearing problem, and you should pay attention to this early.

5. **Signs of distraction**: If your child shows signs of lack of focus, such as seeming to hear some sounds without trying to distinguish them, this may be a sign of a problem.

How can I test the newborn's hearing and what are the methods available to measure hearing in infants?

 

There is no need to worry if you feel that there is a problem with your child's hearing. If you are wondering: How can I test the newborn's hearing? There are several methods to measure hearing and ear pressure in children. It has become easier now thanks to hearing tests dedicated to newborns. It is important to be aware that there are problems that may lead to hearing loss in your child, such as otitis media.

Hearing tests for children are available in several forms, and the appropriate method is chosen based on genetic predisposition, in addition to assessing any risk factors that the child may be exposed to, as well as according to his age.

As for newborn tests, they have become necessary before they leave the hospital or maternity ward. It is important to diagnose hearing loss in a child before he is three months old, so that treatment can begin before he reaches six months. This helps the child overcome the problem and learn to speak correctly, and understand language, which makes him at the same level as his peers when he enters school, without any significant difference or problems.

There are two types of initial screening tests for hearing in newborns, which are painless and do not take a long time, and are preferably performed while the child is sleeping:

**Type 1: OAE hearing test in infants** In this test, a small microphone is placed in the child's ear. Sounds are sent to the ear, and the sounds emitted by the cochlea are recorded in the ear canal. These emissions are analyzed to determine thresholds at certain frequencies. If the child has hearing loss, no sound emission will be recorded, which helps to identify the problem.

**Type 2: Auditory Brainstem Response (ABR) test** Electrodes are used placed in several locations on the child's head and ear. An audio stimulus is delivered to each ear through either headphones or earbuds, which detects electrical activity in the brain. For older children, there are several websites that offer hearing testing. Your child’s hearing can be measured by determining their gender and age, adjusting the volume settings appropriately, and then finding a quiet place to take the test. You can choose between large speakers or a special headset, as the headset provides a more accurate experience.

**Treatment of hearing loss in children**

Early treatment of hearing loss can help many children develop normal language skills without delay. For infants born with hearing loss, treatment is best started at 6 months of age. The type of treatment depends on the child’s overall health and the cause of the hearing loss. Treatment options may include:

**Medical hearing aids:** Your doctor may recommend hearing aids for infants with first- and second-degree hearing loss. These amplify sounds so that they are more understandable to your child. Several types of hearing aids are available, with the most common type being the behind-the-ear type, which is suitable for children whose ears are developing rapidly. There are also bone-anchored hearing aids, which may be helpful for children who cannot use traditional hearing aids.

**Cochlear Implants and Brainstem:** If your infant has severe or profound hearing loss and does not respond to hearing aids, your doctor may suggest a cochlear implant. This procedure involves delivering auditory signals directly to the brain. However, if your child has severe damage to the auditory nerve, a cochlear implant may not be effective, in which case he or she may need a brainstem implant.

**Medications:** Sometimes, children develop hearing loss as a result of chronic ear infections, and antibiotics can help treat this type of hearing loss.

**Corrective Surgeries:** Some infants may develop hearing loss due to abnormalities in the ear structure, a hole in the ear, or fluid buildup. Some surgeries may be helpful to address these problems.

Speech therapy.

Learning sign language.

Ear tube implants to treat recurring ear infections.

**Treatment of hearing loss in children using herbs**

Sudden or temporary hearing loss in children can be treated by identifying the cause and preventing it. For example, throat infections can lead to ear blockages, so drinking hot drinks and herbs that contain therapeutic properties and vitamins may help improve hearing and alleviate the problem.

**Ginger:** Ginger is considered one of the traditional therapeutic recipes that ancestors have used in Eastern societies for many centuries, thanks to its beneficial and effective vitamins. Ginger works as an antihistamine and a pain reliever.In this case, it is considered an antibiotic. It also has anti-inflammatory properties that help calm any inflammation in the nervous system, which plays a vital role in transmitting sound from the ear to the brain. Therefore, herbs that promote a healthy nervous system may contribute to improving hearing.

**Turmeric:** Turmeric is another traditional recipe recommended by ancestors, and is known for its great medicinal value. Turmeric has been used to treat many diseases and health problems since ancient times, due to its potassium content, which is very beneficial for ear health.

**Echinacea**: Echinacea is also known as coneflower flowers, and is a plant that grows in North America. Some research has shown that echinacea is effective as an antibiotic, as it has previously been tested against colds and some other types of infections. Echinacea is also considered an excellent nutritional supplement.