Quick answer: Hearing is your baby’s most developed sense at birth — they’ve been processing sounds since week 18 of pregnancy.
Hearing is your baby’s most developed sense at birth — they’ve been processing sounds since week 18 of pregnancy. Understanding the normal progression of hearing development and what to watch for helps you support this critical foundation for language.
The Newborn Hearing Test
Newborn hearing screening is offered to all babies before hospital discharge or at the first home visit. The automated otoacoustic emission (AOAE) test sends a quiet clicking sound into the ear and measures the cochlea’s response. The automated auditory brainstem response (AABR) measures electrical activity along the hearing pathway. Both tests take 10–15 minutes and are painless. A ‘no clear response’ result does not mean your baby is deaf — it often reflects fluid in the ear canal, a sleeping baby, or ambient noise. Follow-up testing is arranged and is routine.
Hearing Development Month by Month
- Birth: startles to sudden loud sounds; recognises mother’s voice; prefers speech over other sounds
- 1–3 months: quietens or smiles at familiar voices; turns eyes toward sounds
- 3–6 months: looks toward a sound source; responds to music; vocalises in response to voice
- 6–9 months: turns head accurately toward sounds; responds to name; enjoys rhythm and song
- 9–12 months: understands several words; responds to simple instructions; babbling varies in volume and pitch
Signs of Hearing Difficulty
Contact your health visitor or paediatrician if: baby doesn’t startle to sudden loud noises, doesn’t turn toward sounds by 3–4 months, doesn’t respond to their name by 9 months, isn’t babbling with varied consonants by 12 months, has had multiple ear infections, or if you have any gut concern. Don’t wait for a scheduled appointment if you’re worried.
Hearing Aids for Babies
If hearing loss is identified, intervention should begin as early as possible — ideally by 6 months. Modern hearing aids fit babies from birth and are surprisingly small. Early fitting dramatically improves speech and language outcomes — the earlier the intervention, the better the results. Cochlear implants are considered for profound hearing loss not correctable by aids, typically from 9–12 months. Early diagnosis and intervention gives babies with hearing loss equivalent language outcomes to hearing peers.
What glue ear is and why it matters
Glue ear (otitis media with effusion) is the accumulation of fluid in the middle ear, producing a temporary conductive hearing loss. It is extremely common — approximately 80% of children experience at least one episode by age 10, and it is most prevalent between ages 1–3. The fluid doesn’t usually cause pain, which means it often goes undetected until speech development delay or inattentiveness at school prompts investigation. Signs at the baby and toddler stage: not responding consistently to sounds, needing higher TV volume, speech developing more slowly than expected, or seeming more inattentive than peers. Most glue ear resolves spontaneously within 3 months. Persistent or significant glue ear may be treated with grommets (ventilation tubes inserted surgically under general anaesthetic) — a decision made by an ENT consultant based on hearing test results and duration.
Frequently Asked Questions
Can ear infections cause permanent hearing loss?
Recurring ear infections (otitis media) can cause temporary, fluctuating hearing loss due to fluid in the middle ear — this can affect speech and language development if persistent. Most acute hearing loss from infection resolves with treatment. Chronic unresolved fluid may warrant grommets (ear tubes). Discuss with your paediatrician if your baby has had 3+ ear infections.
Does background noise affect hearing development?
High levels of continuous background noise (television always on, very noisy environments) can make it harder for babies to distinguish speech sounds — relevant to language development. It doesn’t damage hearing. But language learning requires clear speech signal, which is harder to extract from a noisy background.
My baby had a failed newborn hearing screen — what happens next?
A follow-up appointment is arranged, typically within 4 weeks. Many babies who fail the initial screen pass the retest — the cause is usually transient (fluid, movement during testing). If the retest also raises concerns, referral to an audiologist follows for diagnostic testing. Throughout this process, most babies turn out to have normal hearing.
Related Reading
- 17 weeks pregnant: your baby can hear you now
- Ear infections in babies: signs, treatment and prevention
- 3 month old baby: sleep regression or just a growth spurt?
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