Your newborn passed the hearing screening at the hospital—wonderful news. But researchers reviewing evidence in Frontiers in Public Health found something important: that single normal test doesn't guarantee your child's hearing will stay perfect. Some types of hearing loss are missed during screening, and some develop later in childhood.
This matters because undetected hearing loss directly affects how children learn language, think, make friends, and do in school. The earlier you catch it, the better the outcome.
What the newborn screening can and cannot catch
Singapore's universal newborn hearing screening is excellent at detecting permanent hearing loss present at birth. But it has real limits. Mild hearing loss, hearing loss in one ear only, and hearing problems that develop slowly over time can slip through. More importantly, some children develop hearing loss weeks, months, or even years after passing their newborn test.
Risk factors that increase your child's chance of later hearing problems
The research identifies several factors that make hearing loss more likely—some present from birth, others emerging later:
- Genetic factors: Some children inherit genes that trigger hearing loss in later childhood
- Infections during pregnancy: Congenital cytomegalovirus can cause delayed hearing loss even when the baby appears healthy at birth
- Premature birth: Very early babies, especially those in intensive care, face higher risk from infections, oxygen treatment, or certain antibiotics
- Severe jaundice: High bilirubin levels can damage the hearing nerve
- Birth complications: Lack of oxygen, infections, or birth trauma increase risk
- Nutritional or metabolic issues: Poor nutrition in the womb or metabolic disorders can affect hearing development
- Certain medications: Some antibiotics and medicines used in newborn care can harm hearing
If your child had any birth complications, monitoring doesn't stop at the hospital
Singapore's healthcare system excels at newborn screening, but this research shows screening is the start, not the finish. Children born prematurely, with jaundice, infections, a NICU stay, or family history of hearing loss need closer follow-up beyond the initial test. Some problems emerge at 6 months, 12 months, or even 2–3 years old.
This is particularly relevant for Singapore families where extended family members share childcare—grandparents and caregivers should also know these warning signs so they can alert parents to changes in your child's response to sound or speech development.
Three steps to take now
- Ask your paediatrician whether your child had any birth risk factors; if yes, plan follow-up hearing checks at 6, 12, and 24 months.
- Watch for signs of hearing difficulty: no response to loud sounds, delayed speech, or unclear speech by age 2–3 years.
- Share your family's hearing history with your doctor; genetic hearing loss may not show up until later childhood.