Not Responding to Sounds (Hearing Concerns) in Babies

Content reviewed against published AAP, CDC, AAP guidelines

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Hearing is critical for language development, and early detection of hearing loss leads to significantly better outcomes. All newborns should be screened before hospital discharge. Babies should startle to loud sounds from birth and progressively respond to softer sounds and voices. Not responding to sounds may indicate temporary hearing loss (from ear infections or fluid), permanent hearing loss, or sometimes developmental differences unrelated to hearing.

Key takeaways

  • Hearing is critical for language development, and early detection of hearing loss leads to significantly better outcomes.
  • Most common cause: Middle ear fluid (otitis media with effusion) causing temporary conductive loss
  • Emergency: Sudden complete hearing loss after head trauma
  • Home care: Test hearing informally: make sounds out of baby's line of sight and observe for turning

Possible Causes

Middle ear fluid (otitis media with effusion) causing temporary conductive losscommon
Deep sleep or being focused on another activitycommon
Chronic ear infections with persistent fluiduncommon
Congenital sensorineural hearing lossuncommon
Auditory neuropathy spectrum disorderrare
Syndromic hearing loss (part of a genetic syndrome)rare
Ototoxic medication exposurerare
Autism spectrum disorder (may not respond socially but hearing is intact)rare

When to Seek Help

Emergency — Call 911 or go to ER:

  • Sudden complete hearing loss after head trauma
  • Not responding to sounds with altered consciousness or neurological symptoms

Urgent — See doctor today:

  • Failed newborn hearing screen (follow-up needed within 1 month)
  • Sudden loss of previously normal hearing responses
  • Hearing loss with high fever, severe ear pain, or meningitis symptoms

Same-day appointment:

  • Concern about hearing after recurrent ear infections
  • Not responding to name by 9-12 months
  • No babbling by 9 months or speech significantly delayed

Monitor at home:

  • Selective hearing (responds to interesting sounds but not commands)—common in toddlers
  • Mild decreased responsiveness during a cold or ear infection
  • Baby who passed hearing screen but parent has intermittent concerns

By Age

0-3 months

Normal: Newborns startle to loud sounds (Moro reflex), quiet to familiar voices, and may turn toward sounds. They may habituate (stop responding) to repeated sounds—this is normal.

Worry if: No startle to loud sounds, does not quiet or respond to parent voice, failed newborn hearing screen, or no response to any sounds by 1 month.

3-6 months

Normal: Baby should turn toward sounds, respond to voice by cooing or smiling, and startle at unexpected loud noises. May look for sound source.

Worry if: Does not turn toward sounds, no response to name by 6 months, no babbling beginning by 6 months, or stops responding to sounds after previously responding.

6-12 months

Normal: Baby should respond to name, turn to locate sounds from different directions, babble with varied consonant sounds, and respond to simple words like "no" or "bye-bye."

Worry if: Does not respond to name consistently, no consonant babbling (ba, da, ga) by 9 months, does not turn to locate sounds, only responds when seeing your face (lip-reading), or speech/babbling not progressing.

1-3 years

Normal: Should follow simple commands, point to body parts on request, have increasing vocabulary, and respond to being called from another room.

Worry if: Significant speech delay, needs TV volume very loud, does not follow simple directions, only responds when facing you, or regression in language skills.

Home Care

  • Test hearing informally: make sounds out of baby's line of sight and observe for turning
  • Clap, ring a bell, or crinkle paper behind baby to check for response
  • Talk to your baby frequently—narrate activities, sing songs, read aloud
  • Reduce background noise when speaking to baby so they can focus on your voice
  • If baby had ear infections, recheck hearing 4-6 weeks after infection clears
  • Keep all audiology follow-up appointments if hearing screen was abnormal
  • Do not assume baby is "just being stubborn"—always have hearing professionally tested if concerned
  • Contact Early Intervention services if hearing loss is confirmed (the sooner the better)

Frequently asked questions

What causes not responding to sounds (hearing concerns)?
Middle ear fluid (otitis media with effusion) causing temporary conductive loss (common); Deep sleep or being focused on another activity (common); Chronic ear infections with persistent fluid (uncommon); Congenital sensorineural hearing loss (uncommon); Auditory neuropathy spectrum disorder (rare); Syndromic hearing loss (part of a genetic syndrome) (rare); Ototoxic medication exposure (rare); Autism spectrum disorder (may not respond socially but hearing is intact) (rare)
When is this an emergency?
Sudden complete hearing loss after head trauma. Not responding to sounds with altered consciousness or neurological symptoms
What can I do at home?
Test hearing informally: make sounds out of baby's line of sight and observe for turning. Clap, ring a bell, or crinkle paper behind baby to check for response. Talk to your baby frequently—narrate activities, sing songs, read aloud. Reduce background noise when speaking to baby so they can focus on your voice. If baby had ear infections, recheck hearing 4-6 weeks after infection clears. Keep all audiology follow-up appointments if hearing screen was abnormal. Do not assume baby is "just being stubborn"—always have hearing professionally tested if concerned. Contact Early Intervention services if hearing loss is confirmed (the sooner the better)
When should I call the doctor?
Concern about hearing after recurrent ear infections. Not responding to name by 9-12 months. No babbling by 9 months or speech significantly delayed

Sources

AAPCDCAAP

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Symptoms

ear painear dischargespeech delay

Bottom line

Most cases of not responding to sounds (hearing concerns) in babies are not emergencies. However, seek immediate care if sudden complete hearing loss after head trauma.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.