It is a common process for babies to have to go through a Newborn Hearing Screening before they can be discharged from the hospital. Usually performed within the first few days after birth, this will help diagnose any hearing problems in the baby.
When Can Babies Hear In The Womb?
Your unborn child will begin to be able to 18 weeks of pregnancy.
Around this time in your pregnancy, your baby can only hear a few noises that you might not even be aware of. They are your body’s sounds. They can hear your heartbeat, the air leaving and entering your lungs, your stomach grumbling, and even the sound of blood flowing through the umbilical cord.
They begin to be able to hear sounds outside of your body, such as your voice, during 27 to 29 weeks (6 to 7 months). When they are fully grown, their hearing will be comparable to that of an adult.
When you speak, they will react by having a faster heartbeat, which shows that they are more attentive. To put it another way, now is a fantastic time to begin reading and singing to them.
Hearing Loss in Infants
Hearing loss can occur when any component of the ear isn’t functioning normally. From mild to profound, it can be:
- Mild: Some speech sounds can be heard, but soft sounds are difficult to hear.
- Moderate: When a person is speaking normally, not many speech sounds may be heard.
- Severe: Even when someone is talking at a normal volume, you cannot hear any speech sounds. Only certain loud sounds are audible.
- Profound: Speech sounds are completely absent. Only extremely loud sounds can be heard.
Being deaf from birth is a frequent congenital condition. Birth defects are structural variations that are evident at birth and can impact practically any bodily part. The body’s functionality, appearance, or both may be impacted. Birth defects can affect a person’s overall health as well as how their body develops and functions.
According to the Singapore General Hospital, about 1 in 1000 babies in Singapore develops significant hearing impairment at birth. This leaves them at risk for delays in speech, language, intellectual, social, and emotional development.
Moreover, even after passing the hearing screening, some babies may still develop hearing impairment gradually. This could be due to recurrent ear infections, genetic factors, or chronic illnesses.
As such, parents are advised to stay vigilant. To help minimise any damaging impact on the child’s development, early detection followed by appropriate intervention is crucial.
Image Source: iStock
Common Types Of Hearing Loss
The part of your baby’s body that aids in hearing is called the auditory system. As sound information goes from the ear to the brain, it is processed. Hearing loss may be brought on by issues with certain auditory system components:
1. Outer ear
The ear canal, eardrum, and portion of the ear that is on the outside of the head are all included in this. The outer and middle ears are divided by the eardrum.
2. Middle ear
This consists of three tiny bones known as ossicles and the interior of the eardrum. The eardrum vibrates as sound enters the ear and travels through the ear canal to the eardrum (moving back and forth quickly). The ossicles are moved by the eardrum when it vibrates. Thus, sound can more easily reach the inner ear.
3. Inner ear
This consists of canals that aid in balance and the cochlea, a curved tube filled with fluid. Additionally, the inner ear contains nerves that convert sound vibrations into impulses that pass through the auditory nerve to the brain (also called the hearing nerve). From the ear, the auditory nerve transmits sound information to the brain.
Among the common forms of hearing loss are:
This occurs when an issue in the middle or outer ear inhibits or obstructs the passage of sound waves. An obstruction in the ear canal or fluid in the middle ear are examples of problems. This form of hearing loss is frequently transient and is typically manageable with medication or surgery.
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Sensorineural hearing loss
This occurs when the auditory nerve or inner ear functions incorrectly. When specific inner ear cells are harmed, it can take place. Typically, this form of hearing loss is irreversible.
This occurs when a baby has both sensorineural and conductive hearing loss.
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Auditory neuropathy spectrum disorder (ANSD)
In this situation, the auditory nerve or inner ear issue hinders the brain from comprehending sound.
What Causes Hearing Loss In Babies?
What causes all types of hearing loss is unknown. Potential reasons include:
1. Genes
Genes are components of your cells that contain instructions for how your body develops and functions. Parents transmit their genes to their offspring. About 40 per cent of infant and child hearing loss instances may be genetically based.
Before becoming pregnant, you might wish to consult a genetic counsellor if either you or your spouse has a family history of hearing loss. This expert has the training to explain how genes, birth abnormalities, and other medical disorders run in families and how they may affect both your health and the health of your unborn child.
Gene sequences can alter from time to time. This is referred to as a gene mutation or alteration. Two different types of hearing loss can result from gene changes:
- Syndromic.
Other medical conditions, such as blindness, coexist with hearing loss.
- Non-syndromic.
When this happens, a baby’s ailment is limited to hearing loss. Seven out of ten (70%) mutations that result in hearing loss are not syndromic.
2. Problems with the way the ears, head or face develop
Your child may experience hearing issues if he has a birth abnormality that affects the structure or form of his ears, head, or face.
3. Viruses and infections during pregnancy
During pregnancy, there are some viruses and diseases that you can give to your unborn child that could harm their hearing. These consist of:
4. Infections your baby has after birth
The following infections can result in hearing loss:
- Infected ears
- Other illnesses, such as measles and meningitis.
5. Other conditions after birth.
These include:
- Head injuries
- Jaundice that is so severe that a blood transfusion is required.
- Using excessive amounts of various medications, such as the antibiotic streptomycin. Antibiotics are drugs that eradicate specific infections.
- Ear wax buildup or fluid accumulation behind the eardrum
- A ruptured eardrum
- Food, toys, or crayon shavings that have become lodged in the ear canal
- Being in close proximity to loud noises, such as machine noise
A screening test will typically be used to identify newborns with hearing loss. Others will experience hearing loss in their early years.
Fluid In Baby Ears Hearing Loss
Otitis media with effusion is the medical term for fluid buildup in the middle ear. The tiny portion of the ear that is just inside the eardrum is known as the middle ear.
It’s possible for your youngster to be completely symptom-free or to experience very moderate ear pressure or fullness. Your child can complain that their ears are congested.
When the little tube that transports fluid from the middle ear to the throat swells and closes due to a cold, an allergy, or another issue, fluid can accumulate. The middle ear fills with fluid if the eustachian tube, as it is also known, becomes obstructed.
The fluid disappears for some kids in a few weeks. However, some kids still have fluid buildup three months after it begins. Your child is more prone to contract another infection if they still have fluid in their ears following an ear infection.
Rarely, fluid buildup that lasts three months or longer may result in hearing issues. However, once the fluid has disappeared, hearing normally returns to normal.
Premature Baby Hearing Loss
Image source: iStock
Premature birth occurs when a baby is born before the mother has been pregnant for 37 weeks. Compared to kids born full-term, premature babies frequently have more health issues both at birth and later in life, such as hearing loss. A newborn who weighs less than 5 pounds, 8 ounces is said to have a low birth weight. Learn more about the things you may do to lower your chance of giving birth prematurely.
Moreover, even after passing the hearing screening, some babies may still develop hearing impairment gradually. This could be due to recurrent ear infections, genetic factors, or chronic illnesses.
As such, parents are advised to stay vigilant. To help minimise any damaging impact on the child’s development, early detection followed by appropriate intervention is crucial.
Signs of Hearing Loss in Infants
In an interview with ‘Living Well’ on Shin Min Daily, Associate Professor Liu Wangjian, a senior consultant doctor at the otolaryngology surgery at Mount Elizabeth Novena Hospital highlights a few signs that parents can observe about their baby to find out if he or she has a hearing impairment:
- The baby has no appropriate responses to the sound of your voice.
- The baby does not get startled by loud noises such as thunder or a door slammed shut.
- The baby has a lack of babbling or cooing.
In addition, Dr Liu further explained that there are certain milestones when it comes to babies’ hearing and language developmental stages.
He advises parents to pay extra attention if there is a delay in milestones relating to baby’s hearing, speech and language development. These are the general indicators, according to him:
- By three months: When talking to the baby, the baby will turn his head in the direction of where the sound comes from
- By six months: The baby will like toys that produce sounds. Upon hearing them, he or she will respond by babbling and repeating the sounds
- Between 6 months to 12 months: The baby should be babbling and saying their first words
- Between 15 months to 18 months: The toddler should start speaking simple sentences and understand simple instructions
Signs of hearing loss in infants: There are certain indicators when it comes to babies’ hearing and language developmental stages. | Image source: iStock
Parents can continue to monitor the behavioural responses of their child’s hearing ability according to the checklist provided in the Baby Health Booklet.
In the event a baby has an ear infection that may affect hearing, Dr Liu explains that babies may have the following symptoms:
- A persistent fever
- The tendency to pull on one or both ears
- Appears to be constantly tired
- A lack of energy
In any instance you suspect that your child has a hearing problem, do consult your doctor.
When and How Will The Screening Be Done?
The hearing screening typically takes about 15 to 30 minutes and will be performed by trained staff. It is safe and will not pose any dangers to your child.
According to Mount Elizabeth Hospitals, the doctor is likely to perform a range of tests to assess your child’s hearing ability. These could include the following:
- Physical ear exam — allows for the checking of inflammation caused by an infection or excess wax
- Clinical screen tests — allows for the checking for responses to voices at various intensities
- The use of tuning forks to assess a child’s responses to sounds
- Detailed audiometric tests with earphones
Young children who face difficulties in understanding and following instructions may be required to undergo objective hearing tests under sedation.
Parents should also ensure that their child receives all necessary vaccinations and undergo regular checkups with their doctor. This could help prevent illness and infection that could lead to hearing loss.
Updates from Matt Doctor
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