Tests · Paediatric hearing
Newborn hearing screening: what it is and when to do it
Newborn hearing screening, using otoacoustic emissions, checks whether the cochlea — the hearing organ — is responding to sound. It is quick, painless and carried out while the baby sleeps. It should be done while still in the maternity unit, within the first 15 days of life.
Medically reviewed by Prof. Aline Bittencourt, MD, PhD, CRM-MA 7562 · RQE 1832 Updated on
How does the test work?
Besides receiving sound, the cochlea produces a sound of its own, very faint, when stimulated. That echo is called an otoacoustic emission. The test presents a sound stimulus through the probe placed at the entrance to the ear and checks whether that echo appears.
If it appears, the cochlea is working. If it does not, the test is recorded as a “refer” — which is not synonymous with hearing loss, only with the need for reassessment.
Why do it so early?
Because the first years of life are when the brain organises language from what it hears. Identifying hearing loss early allows intervention to begin within that window. Hearing loss discovered at three years of age costs developmental time that cannot be recovered.
What happens if the baby does not pass?
The usual path is this:
- Repeat the screening, within 15 days.
- If the finding persists, investigate with further tests — particularly ABR, which measures the auditory nerve response, and tympanometry, which assesses the middle ear.
- Consultation with an ENT specialist, for examination of the ear and interpretation of everything together.
None of this is cause for panic. It is cause for not letting it slide.
Who performs it at Clínica Rhinus?
The test is carried out by the speech-language pathologists on our team. Where a change is found, investigation continues at the clinic itself, with the other hearing tests and the medical assessment.
How should I prepare for this test?
- Bring the medical request: it is required for all tests, whether under insurance or self-pay.
- Bring the baby fed; the test is easier while the baby sleeps.
- Comfortable clothing and a calm environment help.
- Bring the maternity records and any previous results.
Sources: Brazilian Association of Otorhinolaryngology and Cervico-Facial Surgery (ABORL-CCF) · Flint PW, Francis HW, Haughey BH, et al. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Elsevier; 2020. · Bento RF, Bittencourt AG, Voegels RL. Seminários em Otorrinolaringologia. Fundação Otorrinolaringologia.
Frequently asked questions
Questions about paediatric hearing
What is newborn hearing screening and when should it be done?
It is neonatal hearing screening, carried out with the otoacoustic emissions test. A small probe is placed at the entrance to the ear and captures the cochlea's response to a sound stimulus. It is best carried out while still in the maternity unit, within the first 15 days of life.
My baby did not pass. Is he deaf?
Not necessarily, and this matters. Residual fluid in the ear, vernix in the canal or an unsettled baby can all affect the result. The standard procedure is to repeat the test within 15 days and, if the finding persists, proceed to further tests such as ABR. Most babies who do not pass the first time have normal hearing.
Does the test hurt or cause discomfort?
No. There is no needle, no radiation and no contrast. The probe is soft and stays only at the entrance to the ear canal. Most babies sleep through the whole test.
My child passed. Should I still think about hearing later?
It is worth staying alert. Some hearing loss appears after birth, following infections, medications or genetic causes with delayed onset. If speech is delayed, if there are recurrent ear infections, or if the family has any concern, hearing should be reassessed even after normal screening.