Preventing Hearing Loss in Kids

Excellent hearing is crucial to a child’s health and development. Poor hearing, even if mild, can cause problems in communication, learning, speech, and social skills. There are multiple reasons a child may develop hearing loss, including chronic ear infections, trauma, certain medications, and vaccine-preventable serious brain infections like meningitis.

In 2023 the American Academy of Pediatrics released a policy statement concerning one of the most preventable causes of hearing loss—excessive noise exposure, calling this a “largely unrecognized … serious public health hazard”. This type of hearing loss can be temporary or permanent. Over 12% of kids aged 6-19 years and 17% of adults under age 70 have permanent hearing damage from loud noise exposure.

Because children have smaller ear canals, higher frequency sounds are more intense and potentially more damaging. Think of noise as ‘dose-related’; the longer the exposure, the more risk even if just slightly louder than what is considered safe. Sounds over 75 dB for older children and adults can cause damage, depending on length of exposure. Noises we consider routine like city traffic, TV, and lawnmowers can harm children’s hearing. Concern has also been raised about infant sound machines used to help babies fall asleep. Since infants can have damage beginning at 60 dB, it is recommended to keep a noise level at 50 dB or lower, but sound machines may exceed this.

Depending on your child’s age, hearing loss can present differently. They may not meet developmental milestones. A 3-month-old should alert to a sound and babble back and forth. By 6 months, you should hear some consonants (“mamamama”, “dadada”, etc.). A 1-year-old will follow simple directions like, “Look at Mommy!”. Toddlers and older kids with hearing loss may have unclear speech, say “Huh?” a lot, and want the volume of TV or music turned up. Acute loud noise exposure can also cause ear pain and ringing in the ears (“tinnitus”).

Personal listening devices (PLDs) such as iPods, smartphones with earbuds, and headphones for watching TV can magnify the risk. The World Health Organization estimates 1.5 billion people worldwide are risking hearing damage from ‘unsafe listening practices’.

We can start early to protect our child’s hearing. Checking decibels in your child’s environment is helpful although decibel apps on phones are not 100% accurate. Anything over 85 dB can harm an adult’s hearing, and over 70 dB can impact a child. The louder the noise, the faster it can cause damage. 

Infant sound machines should be at least 7 feet away from a baby and at 50 dB max. Consider avoiding loud noise exposure (concerts, fireworks, etc.) but if unavoidable, younger children can wear sound protecting earmuffs (plastic cups connected with a headband) over their ears. Ear plugs are safe for older kids and there are different types; ‘musician earplugs’ dampen volume yet preserve audio quality better than foam earplugs from the drugstore.

Be a good role model by setting good rules for hearing protection and wear ear plugs yourself when appropriate. Set clear expectations for protecting every family member’s hearing. Loud background noise can also be distracting, worsen a child’s mood, and disrupt learning, so routinely having a quiet home at times can be a benefit. If you have concerns, talk to your child’s health care provider about getting a formal hearing evaluation by an audiologist.