Newborn hearing screening is one of the point-of-care checks every baby receives, usually before leaving the hospital. It is not a blood-spot test; it is a quick, painless check of how a newborn’s ears and hearing pathways respond to sound. Permanent hearing loss is one of the most common conditions present at birth, affecting roughly 1 to 3 of every 1,000 newborns, and catching it early makes a lasting difference for speech and language development.
What newborn hearing screening checks for
The screen looks for permanent congenital hearing loss in one or both ears. Identifying it in the first weeks of life, rather than months or years later, lets families begin support and intervention during the critical window when the brain is learning to process language. This is the goal behind the widely used 1-3-6 guideline: screen by 1 month, diagnose by 3 months, and begin intervention by 6 months.
How the screen works
Two safe, painless methods are used, often while the baby sleeps. Otoacoustic emissions (OAE) place a small soft probe in the ear to measure the sound the healthy inner ear naturally echoes back. Automatic auditory brainstem response (AABR) uses soft earphones and sensors on the head to measure how the hearing nerve and brainstem respond to sound. Neither method requires any response from the baby.
What happens if your baby does not pass
Not passing the first screen does not mean a baby has hearing loss. Fluid or vernix in the ear, or movement during the test, can cause a "refer" result. The next step is a repeat screen, and if that is not passed, a referral to a pediatric audiologist for a full diagnostic evaluation. Prompt follow-up is what keeps a baby on the 1-3-6 timeline.
The genetic side of hearing loss
About half of congenital hearing loss has a genetic cause, and much of that is non-syndromic, meaning hearing loss is the only feature. Variants in the GJB2 gene (which makes a protein called connexin 26) are the single most common cause. Because the newborn hearing screen measures function rather than genes, it cannot tell you why a baby has hearing loss or whether it is inherited.
How genetic screening fits in
State newborn screening does an excellent job of catching hearing loss. Genetic screening looks at the same picture from the DNA level and, in a single test, can also assess the genes tied to more than 1,000 other clinically actionable childhood conditions, many of which are not on any state panel. Fore Genomics offers an at-home cheek-swab screen, sequenced in CLIA-certified and CAP-accredited labs, with results supported by board-certified genetic counselors. See how your state’s panel compares, see what we screen for, or start screening.
Frequently asked questions
Is newborn hearing screening done in every state?
Yes. Universal newborn hearing screening is standard practice across all U.S. states, typically before hospital discharge.
Does the hearing screen hurt my baby?
No. Both the OAE and AABR methods are painless and are usually done while the baby rests or sleeps.
My baby did not pass. Should I worry?
A "refer" result is common and often caused by fluid or movement, not hearing loss. It simply means your baby needs a repeat screen and, if needed, an audiologist evaluation.
Medically reviewed by Fore’s Clinical Team. This article is for general educational purposes and is not medical advice. Sources: CDC Early Hearing Detection and Intervention (EHDI); American Academy of Pediatrics.