Does the Early Hearing-loss Detection, Diagnosis and Intervention (EHDDI) program follow-up on infants who pass their newborn hearing screen but have risk factors for delayed onset hearing loss?
The EHDDI program will send a letter to the infant's provider if an infant has a syndrome associated with hearing loss, a family history of hearing loss, a craniofacial anomaly, or if the mother had an infection that puts the infant at risk for having a hearing loss. The EHDDI program will not follow-up on infants whose only risk factor is an extended stay in the Neonatal Intensive Care Unit (NICU).
At what level of hyperbilirubinemia do you recommend that an infant receive an Auditory Brainstem Response (ABR) screening?
Infants who reach a total serum bilirubin level of 20 mg/dL or have received an exchange transfusion should be referred for an ABR screening.
Do well-baby infants who receive 1-2 days of ototoxic drug treatment need an ABR screening?
If the infant has no other risk factors, an infant who has only received a 1-2-day treatment with ototoxic drugs does not need an ABR screening. Otoacoustic Emissions (OAE) screening is sufficient.
Is there a specific length of exposure to aminoglycosides that requires that an infant have a diagnostic evaluation?
There is extreme variability among patients and no correlation between dosage of aminoglycosides and the resulting hearing loss. Some patients have taken a small dose without developing hearing loss while others develop hearing loss. Researchers have suggested that there is a genetic predisposition to ototoxicity. Taking a conservative approach seems appropriate given there is no way of knowing which child may be impacted. However, an infant who has received a 2-day course of antibiotics (commonly given to rule out sepsis) does not need a full diagnostic evaluation.
If an infant is in the NICU should they receive an ABR screen?
Yes, infants in the NICU should receive an ABR screen because they are more likely to have neural conduction disorders, which are not detected through screening with OAE.
If the mother receives ototoxic medication, does the infant need a diagnostic or screening ABR?
No. An infant does not need an ABR if the mother has received ototoxic drugs (assuming the infant has no other risk factors for late onset hearing loss).