Early Hearing Detection and Intervention
Out of Hospital Births: At Birth
Closing the follow-up gap: Out of hospital births
Role of Midwives
There are many midwives throughout the state of Minnesota with access to screening equipment who have been trained by our program's audiologists to perform newborn hearing screening. The Minnesota Council of Professional Midwives (MCCPM), for example, has distributed hearing screening equipment to trained members practicing across the state to screen newborns for hearing loss. MCCPM members also offer newborn hearing screening to families who are not clients in their practice. Please visit our Midwives Offering Newborn Hearing Screening page for a list of midwives who offer hearing screening.
Midwives who do not have access to hearing screening equipment should educate parents about newborn hearing screening and set up a hearing screening appointment with another provider before the infant is one month of age. Midwives who refer families to other providers for hearing screenings are encouraged to fill out the Notification of Newborn Hearing Screening Appointment form and fax or mail it to our program staff. Copies of this form can be ordered free-of-charge on the Education Materials and Forms page.
Important Steps to Cover
Educate parents about newborn hearing screening
Schedule infants for screening with another provider if unable to provide hearing screening at your site (Midwives Offering Newborn Hearing Screening, Specialist Resources: Diagnostic Audiology Centers)
Prepare quiet infant for testing
Screen both ears by 3 days postpartum (OAE Testing Steps & Do's and Don'ts)
Rescreen by 2 weeks postpartum if initial results is a REFER (REFER=did not pass) (Newborn Hearing Screening Flowchart: Out-of-Hospital Births)
Document results in baby's medical record and hearing screening log book
Report results to the parent, primary care provider, and MDH Newborn Screening Program
Schedule appointment for diagnostic audiology evaluation as soon as possible for infants who did not pass their rescreen (Specialist Resources: Diagnostic Audiology Centers)
Have a plan for missed screens and equipment breakdown
Tips for Improvement
Misconception: Hearing loss does not occur very often, so newborn hearing screening is not necessary.
Clinical Fact: Hearing loss affects about 1-3 per 1000 births, and is considered to be one of the most common congenital findings.
Misconception: Parents can test a child's hearing by clapping their hands or banging pots near the child.
Clinical Fact: Some babies with hearing loss can still startle to loud noises or respond to some sounds, but may not be able to hear all the sounds important for speech. Thorough hearing testing is needed to find all types/levels of hearing loss that can affect speech/language development.
Misconception: There is no rush to identify hearing loss.
Clinical Fact: Children identified with hearing loss after 6 months of age are more likely to have speech and language delays. Children identified before this time, can avoid these delays through evidence-based early intervention.
Materials marked with * are available to order free of charge on the Minnesota Newborn Screening Program website.
Resources for Providers
Resources For Families
Resources In The Community
Newborn Hearing Screening Training (NCHAM)
The National Center for Hearing Assessment and Management (NCHAM) provides Newborn Hearing Screening Training (full screen)
- See Module 3 for Otoacoustic Emissions (OAE)
- See Module 4 for Automated Auditory Brainstem Response (A-ABR)
Standardize the process for documenting all newborn screening results in the baby's medical record
Record and report the results to the state EHDI program via MNScreen, the electronic reporting system
Use standardized communications (written and verbal) to parents about newborn screening results
Verify the PCP/Medical Home (vital to ensure accurate follow-up)
Communicate did not pass results to the PCP/Medical Home as a modified critical value requiring confirmation
Identify two points of contact for families of infants who did not pass (i.e. a relative or friend)
Provide clear communication about next steps
Schedule any needed follow-up appointments, stressing importance with families
Offer a referral to local public health for infants who did not pass