Newborn & Infant Hearing Tests: OAE, BERA & What a “Refer” Result Means
by Crystal Hearing Solutions
If your newborn’s hearing screening came back as “refer,” it’s completely natural to feel worried. Take a breath. A “refer” result is very common and does not mean your baby is deaf. It simply means the screening needs to be repeated or confirmed with a more detailed test.
What does a “refer” result mean on a newborn hearing test? It means the quick screening test (usually an OAE) didn’t get a clear response in one or both ears, often due to harmless reasons like fluid or vernix left in the ear canal after birth, or background noise during the test. The next step is a repeat screening or a confirmatory BERA test, not a diagnosis.
Here’s how newborn and infant hearing testing works in Mumbai, what each test does, and exactly what to do next, explained gently, by audiologists who test little ones every week.
Quick Answer: Your Baby’s Hearing Test
Newborn hearing tests are painless and done while your baby sleeps. The first is usually an OAE screening (a soft probe checks the inner ear). If the result is “refer,” the next step is a repeat OAE or a confirmatory BERA test, which objectively measures the hearing nerve’s response. A “refer” is a flag to investigate, most babies who are referred turn out to hear normally. If a hearing loss is confirmed, starting support early (ideally by 6 months) makes a huge difference to speech and language.
Why Newborn Hearing Screening Matters
Babies learn to speak by listening, and the first months are a critical window for brain development. Audiologists follow a simple “1–3–6” guideline: screen by 1 month, confirm any diagnosis by 3 months, and begin support by 6 months. Catching hearing loss early, and acting on it, helps a child develop speech, language and learning on track with their peers.
The Two Tests: OAE Screening & BERA Confirmation
The OAE (Otoacoustic Emissions) test is the quick first screen: a tiny soft probe plays gentle sounds and measures the echo the healthy inner ear sends back. It takes a few minutes and is done while the baby is calm or asleep.
If the OAE result is “refer,” the confirmatory test is a BERA test (also called ABR). Soft sensors on the head record how the hearing nerve and brainstem respond to sound, an objective measure that doesn’t rely on the baby reacting. You can read our full guide to the BERA test for what to expect.
| Test | What it checks | How the baby is | Role |
|---|---|---|---|
| OAE | Inner-ear (cochlea) response | Awake & calm or asleep | Quick first screening |
| BERA / ABR | Hearing nerve & brainstem response; thresholds | Natural sleep (or mild sedation) | Confirms & measures the loss |
Hearing Milestones: What to Watch For by Age
Even after a clear screening, keep an eye on these milestones. Mention it to your paediatrician or an audiologist if your child isn’t:
- 0–3 months: startling at sudden loud sounds; calming to a familiar voice.
- 4–6 months: turning toward sounds; enjoying rattles and musical toys.
- 7–12 months: babbling, turning when you call their name, responding to “no.”
- By 18 months–2 years: using single words, following simple instructions, copying sounds.
For toddlers and older children, we use gentle, play-based testing. See our play audiometry for kids.
If Your Child Does Have Hearing Loss
If a loss is confirmed, the good news is that today’s options are excellent and early support works beautifully. Depending on the type and degree, that may include paediatric hearing aids for children, listening and language therapy, and regular follow-ups as your child grows. Our team will guide you through every step with patience and clarity.
Frequently Asked Questions
Not at all. Both the OAE and BERA tests are completely painless and non-invasive. Just a soft probe or gentle sensors on the skin. Most babies sleep peacefully through the whole thing.
For the OAE screen, calm or lightly asleep is ideal. For a BERA, the baby does need to be asleep so the recording is clean, usually managed with natural sleep after a feed. We’ll tell you how to time the feed and nap before you come in.
No. “Refer” means “please check again,” not “hearing loss.” Many referrals are caused by fluid or vernix in the ear canal soon after birth, or noise during the screening. A repeat test or a BERA will give a clear answer, and most referred babies hear normally. The important thing is simply to do the follow-up promptly.
As early as possible. The widely followed guideline is to confirm any diagnosis by 3 months and begin support (such as hearing aids and therapy) by 6 months. Early action gives a child the best possible start for speech and language, so prompt follow-up of any “refer” really matters.
OAE (Otoacoustic Emissions) ek tezz aur dard-rahit screening test hai jisme kaan mein ek mulaayam probe upkaran lagakar andar ke kaan (cochlea) ki awaaz ke prati pratikriya jaanchi jaati hai. Yeh navjat shishu ki sunne ki kshamta jaanchne ka pehla kadam hai. Agar result “refer” aaye, to ghabraayein nahi, agla kadam dobara screening ya BERA test hota hai. (OAE is a quick, painless newborn screening. A “refer” result just means a re-check is needed.)
Book Your Baby’s Hearing Test
Whether you need a first screening or a follow-up after a “refer,” our gentle, paediatric-experienced audiologists are here to help across our 10+ clinics in Mumbai, Navi Mumbai and Thane.