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Liz Unruh (Host): Hello, listeners, and thanks for tuning in to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Liz Unruh. And joining me today is Jana Wahlen, an audiologist with Riverside Hearing Specialists, who is here to talk to us about newborn hearing screenings and tell us why some babies may need some follow-up testing and what parents can expect next. Thanks for joining us today.

Jana Wahlen: Thanks for having me.

Host: So, this is not your first podcast with us. But can you remind our listeners what you do here at Riverside?

Jana Wahlen: Yes, absolutely. So, I work over at the pavilion on the sixth floor. And we want to make sure people know that our office is still open and we're doing audiology testing there. We've lost some ENTs over the past year. We're trying to get some in. But until then, the office is open. Please call and come get your hearing tested.

Host: Yeah. So, today, we're going to be talking about newborn hearing screenings and understanding the next steps. Before we start, can we talk a little bit about what an audiologist is versus an ENT, and what role each of those kind of play in a baby's hearing care?

Jana Wahlen: Absolutely. So, some people do have some misconceptions, confusions about an ENT, an ear, nose and throat physician, versus an audiologist, who is a doctor of audiology. So, audiologists are hearing specialists. We test hearing, diagnose balance disorders, auditory processing problems, fit hearing aids, cochlear implants, that type of thing, whereas an ear, nose and throat doctor is a physician who is going to treat ear, nose and throat disorders.

Host: Okay. So, that's a great explanation of the difference between those. It's a great knowledge to have going into this conversation. When you're in the hospital, right after you have a baby, a newborn goes for a hearing screening as part of their testing before they're released from the hospital. Can you talk about some reasons why a baby might not pass that initial hearing screening?

Jana Wahlen: Sure. So, all babies are mandated, it's mandated to have their hearing tested before they leave the hospital. And often, when babies are born, the amniotic fluid can get into the middle ear and doesn't drain out. So, I think the nurses do try to wait a little while to do the hearing test hoping that the fluid will drain. But often, babies will leave the hospital and they may have failed the hearing test because of that. That's probably the biggest reason.

And with any screening, you know, things can go wrong. So, there could be a user error, machine error, but that's why we screen. So, they would be referred to come get another screening by an audiologist—me—within two to four weeks of leaving the hospital.

Host: Okay. I know we mentioned before we started recording today, but it's not just babies born in the hospital that need this hearing screen. Even home birth babies will need this screening. Can you talk about that and, like, how someone would get a hearing screening if they had a home birth?

Jana Wahlen: Yeah, absolutely. I'm glad you brought that up because I think sometimes it goes by the wayside. But there are many home births these days. It's still mandated that those babies get a hearing screening in the first month. So, those mothers should call the office as soon as possible and schedule an appointment for a screening test.

Host: Yeah. So if a baby doesn't pass their newborn screening, does that mean that they have hearing loss? I know we touched on, like, some of the reasons why someone might fail it, but could it be if they might have failed it? Does it always mean hearing loss?

Jana Wahlen: No, it usually doesn't mean hearing loss. So, about two babies out of 1,000 will be identified with a hearing loss at birth. So most of the time, it's due to fluid in the ear or some other reason.

Host: Okay. So, what happens after a baby fails? Like, how do they schedule follow-up testing? Like, what would they expect at that appointment that they schedule with you?

Jana Wahlen: Right. So, we are encouraging the mothers to call from the hospital actually if the baby fails that screening and get that set up right away so they don't have to worry about that when they're back home and they're just inundated with everything. We encourage them to make an appointment, like I said, for two to four weeks out. And the reason is it gives the ears time to hopefully, if there is fluid in the ear, it'll drain out by then.

And then, also, those babies are still very sleepy when they're two to four weeks old, and we really need them to be sleeping. It's the best way to test them because the test is very sensitive to any kind of movement. So, we do schedule an hour-long for that appointment because even if they are sleepy, they don't always do what you expect them to do. So, sometimes we need to give mom time to feed the baby and get them back to sleep. We'll do a test and give them the results immediately, and they'll know if there's a problem.

Host: Yeah, I think those immediate test results are a great reassurance or answers for a mother who might be like, "What do you mean I had to come in for a hearing test for my newborn baby?" Just you're anxious about so many things in that first month or so of motherhood, no matter how many children you have, just that reassurance of the answer right away is huge.

Before we continue our conversation, we're going to take a quick break to talk about the importance of primary care.

At Riverside, our primary care providers are right here in your community, offering personalized care for you and your family close to home and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing everyday concerns when they pop up, because remarkable care should never be out of reach. Remarkable care, right where you live.

To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

So, how do you test? I know you said you have to have them sleepy, but how do you test the hearing of a newborn or a young baby who can't actually tell you, like, "Hey, I can hear that"?

Jana Wahlen: Yeah. A lot of people wonder about that. There's some objective test measures that we use to test the babies. The one that we use at Riverside is called an OAE test. It stands for otoacoustic emissions. It's a little complicated to explain what it all tests, but basically the baby comes in sleeping. I put a very soft little earphone in their ear that introduces different sounds, different frequencies.

And if you have a normal inner ear, a normal cochlea, part of that sound will bounce back. It's called like an echo or an emission. And then, there's a microphone in that little probe tip that picks that up and records it. And it's very, very quiet. That's why the baby has to be so still. If we get those emissions or those echoes off the cochlea, we can be pretty sure that the baby is likely to have normal or near normal hearing.

Host: Okay. Yeah, that's interesting. I guess having never had a hearing test myself that I remember, that would definitely explain that. Like, you can use microphones and bounce sound similar to how an echo would work. So if this follow-up hearing test does identify that there could possibly be hearing loss, what happens from there, or what options are available to families?

Jana Wahlen: Yeah. So if the baby fails that rescreen and we don't think it's due to fluid in the ear, I would refer them to a pediatric audiology facility where they could have a full diagnostic workup to see if there is a hearing loss.

The guidelines for the hearing screening program in Illinois is by one month they should be screened. By three months, they should have a full diagnostic evaluation. And by six months if they do have an identifiable hearing loss, they should be referred for early intervention services, which would include speech language therapy and other things like that.

Host: Yeah. Mentioning speech. So, is that part of why it's important for identifying hearing loss so early? Like, how does that impact language and overall development?

Jana Wahlen: Absolutely. So, babies right from the start are listening and picking up things through their environment. It's called incidental learning, incidental listening. And if you think about it, you know, you want your baby to hear right from the start. Those affect their neural pathways. It affects their speech and language development. So, the earlier, the better.

Host: Yeah. I think that's an important thing to remember is hearing is not just hearing, it's also how we learn and how we interact with our environment.

For a parent who may have just learned that their baby needs additional hearing testing and may be worried, what would you tell them to reassure them? And again, I know we mentioned it, but just remind them how they can schedule follow-up care.

Jana Wahlen: Sure. So, obviously, mothers are very worried when they come in after the baby fails that screening. So, I do assure them that it's likely that it was something due to fluid. Try not to worry till we get the test done. Even if we go ahead and do identify the hearing loss, I remind them that we're catching it so early that we'll be able to aid that baby with hearing aids or cochlear implants or whatever is necessary for them and get them the help they need. And there's no reason why they can't go on to develop normal speech and language and have a normal life.

Host: Yeah. And people would schedule by calling your office. And they can find that information on the website. They can ask at the family birthing center if they're here at Riverside.

Jana Wahlen: Yes, absolutely. Like I mentioned, they should get that information when the baby fails in the nursery, and maybe even be prompted to call the office at that time. We're trying to really make sure that the babies follow up in a quick manner.

Host: Yeah. Well, thank you so much for joining us today.

Jana Wahlen: You're welcome. Thanks for having me.

Host: Thank you for tuning into the Well Within Reach podcast with Jana Wahlen with Riverside Hearing Specialists and your host, Liz Unruh. Be sure to like and subscribe to the Well Within Reach podcast on Apple, Spotify, or wherever you get your podcasts. To learn more about the services available at Riverside Healthcare, go to riversidehealthcare.org.