In short: a “repeat test needed” result on a newborn hearing screen does not mean your baby is deaf or hard of hearing. Screening identifies children who need further assessment; it is not a diagnosis. In France, another test is offered when the first is inconclusive, followed by specialist assessment when necessary. The most important thing is to complete the follow-up, even if your baby seems to respond to voices at home.
Birth brings many checks, recommendations and unfamiliar words. Alongside feeding and sleeping, parents may hear “otoacoustic emissions”, “automated auditory brainstem response”, “no response detected” or “inconclusive screening”. These phrases can be alarming when they concern a newborn. But they have precise, limited meanings. Understanding what was actually measured makes it easier to take the next step without jumping to conclusions.
This guide describes the French pathway as presented by Assurance Maladie and the French National Authority for Health in 2026. It does not replace individual instructions for premature babies, babies admitted to neonatal care or children with specific risk factors.
Why check hearing so early?
Hearing helps a newborn discover voices, rhythms and sounds in their surroundings. It contributes to the interactions that gradually support communication. Some hearing differences are present from birth; others develop later. Early screening offers a chance to identify children who need a closer assessment and, where appropriate, timely support.
The French national programme was reviewed by the Haute Autorité de santé in June 2025. Its purpose is not to assign every baby a permanent label before discharge. It is an initial screening stage, with further examinations when indicated. That is why an inconclusive result matters but must not be treated as a diagnosis.
Responding to a voice is not the same as passing a hearing test. A baby may detect some sounds but not others; they may also be asleep, tired or focused on a face. Conversely, failing to startle at a noise proves nothing on its own. Screening uses objective measurements precisely because visible reactions are unreliable as a diagnostic method.
Screening, repeat check and diagnosis are different
Screening asks whether the expected response is detected during a standardised test. It cannot establish the cause or degree of a possible hearing difficulty. A repeat check gathers more information when the first measurement is insufficient. A diagnostic assessment is performed by specialists using tests suited to the child's age, medical history and circumstances.
This distinction prevents two opposite mistakes: treating a “repeat test” result as confirmation of hearing loss, or ignoring it because the child seems to hear household sounds. An inconclusive result is an instruction about the next step in care. The French health insurance guide updated in July 2026 explains the pathway.
What happens during the maternity-unit test?
Parents receive information and are asked for their agreement. Screening is usually carried out while the baby is calm or sleeping. A trained professional places a small device near the ear or uses sensors suited to the chosen method. The newborn does not have to understand instructions or consciously indicate that a sound was heard. The examination is non-invasive.
Protocols vary depending on the service and the baby's medical circumstances. Parents do not need to choose the equipment, but they can ask whether both ears were tested, whether the result was interpretable and where it will be recorded. The French child health record provides an important reference for future consultations. If screening did not happen, ask how a catch-up test will be arranged.
Otoacoustic emissions and automated auditory responses
Evoked otoacoustic emissions detect a response produced by the inner ear after sound stimulation. Automated auditory brainstem responses record electrical activity along the auditory pathways. Neither method requires a deliberate response from the baby. They may be used according to local protocols and medical circumstances.
A numerical screening threshold is not a complete audiogram. An automated screening test alone cannot determine the severity or type of hearing loss. Specialist examinations are used for that purpose when needed. Parents will usually benefit more from understanding the practical conclusion than from trying to interpret every technical setting.
What does a satisfactory result mean?
A satisfactory screening result means that the expected responses were recorded at the time of testing. This is reassuring, but it is not a lifelong guarantee. Some hearing problems appear later, while other children need extra monitoring because of known risk factors. Routine paediatric visits therefore continue to consider hearing, development and communication.
There is no need to monitor every head movement or startle. However, a persistent concern deserves discussion with a healthcare professional, even when newborn screening was normal. The US CDC makes the same point about the limitations of an initial screen.
What does “inconclusive” or “repeat required” mean?
It means the expected response was not recorded reliably enough, or the test did not provide a conclusive result. Technical conditions, the ear canal, movement and background noise may contribute. Follow-up testing is needed to clarify what happened. An inconclusive result is not a diagnosis, but it should not be filed away without action.
French perinatal networks, including Réseau NEF, stress this distinction. A follow-up appointment should be offered when the protocol requires one. Responding to familiar voices at home does not cancel the need for that appointment. Likewise, sleeping through a sound on one evening does not establish a hearing problem.
What are the timelines in France?
Assurance Maladie states that the first screen is offered after 24 hours of life. If inconclusive, a second test is offered at least twelve hours later, before discharge. If the second is also inconclusive, the maternity service arranges specialist follow-up within one month, with parental agreement. Necessary diagnostic examinations should be completed before the end of the baby's third month. These are French pathway targets, not dates to wait for before taking action.
The HAS recommendations from 2025 call for screening both ears, an initial stage with two maternity-unit tests, and further assessment in the first month when needed. For premature babies, corrected age may be relevant. Instructions from the child's own care team take precedence over a general timeline found online.
Practical table: what should parents do?
| Situation | Meaning | Useful next step |
|---|---|---|
| Satisfactory test | Expected response recorded | Keep the result and continue routine follow-up |
| First inconclusive test | Initial information insufficient | Attend the offered second test |
| Second inconclusive test | Specialist assessment needed | Secure the appointment and keep the report |
| No test performed | Screening information missing | Request catch-up screening |
| Concerns despite a normal result | Hearing can change later | Speak to the child's doctor |
This table is an organisational aid, not an individual medical protocol. If the report uses different wording, ask the professional who performed the test to explain it.
What if screening was not performed?
Early discharge, home birth, hospitalisation or technical difficulties can explain why the usual screening was missed. This does not mean screening is no longer worthwhile. The HAS recommends a catch-up pathway for newborns who were not screened. Contact the maternity unit, paediatrician or regional perinatal network to arrange it.
Have the baby's date of birth, health record and any neonatal-unit reports ready. Ask who books the appointment, where it will take place and how the result will be shared. If you move to another region, mention that screening is still outstanding. Good communication between services is a very practical part of prevention.
Only one ear needs a repeat check: does it matter?
Yes. Different results between the ears do not establish that the issue is minor. The HAS recommends screening each ear. A possible one-sided hearing difference deserves proper assessment, because sound localisation and listening in noise may be affected. A repeat examination may also show that no hearing impairment is present.
Avoid comparing your baby's result with another child's. Technical conditions and medical history matter. The useful questions concern your own baby: which ear, which test, what is the next step and when will it happen?
Premature babies and neonatal care
Babies born prematurely or admitted to neonatal units may follow adapted protocols. Professionals consider their medical history and how reliable the tests are in their circumstances. The HAS refers to corrected age for some timelines in premature infants. It is therefore unsurprising that two families describe different screening experiences.
Before discharge, ask whether both ears were screened, whether any identified risk factors require further monitoring and who will receive the results. The family doctor, paediatrician and hospital teams should have consistent information. Parents are not expected to reconstruct a technical medical file, but it helps to check that planned appointments are actually booked.
What happens at a specialist hearing appointment?
The specialist reviews the pregnancy, birth, medical history and previous test results. They examine the ears and choose assessments suitable for an infant. Auditory evoked responses, otoacoustic emissions, middle-ear examinations and age-appropriate behavioural observations may be combined. The aim is to determine whether hearing loss exists, what kind it is and which next steps are appropriate. Some examinations need repeating to obtain reliable measurements.
Four useful questions are: “What was found in each ear?”, “Is another examination needed?”, “What is the recommended timeframe?” and “Who will receive the report?” The Paris-region newborn hearing screening coordination service explains the possible elements of a specialist assessment. The clinician will explain which ones apply to your child.
If hearing loss is confirmed
A diagnosis can bring many emotions. There is no single correct reaction. The priority is clear information about the type of hearing difference, its possible consequences, any further tests and the support available. Options may include medical follow-up, hearing technology when appropriate, communication support and language choices discussed with the family.
A screening result alone cannot predict a child's future. Early identification aims to make useful support available at the right time. Families should have opportunities to ask questions and receive individualised information, without unrealistic promises or frightening predictions.
Observe your baby's listening without home “tests”
Talk to your baby, sing gently, respond to vocalisations and notice moments of attention. These are natural interactions, not tests to pass. Avoid clapping close to the face, making sudden loud noises or using powerful sound toys to provoke a startle. Such methods cannot reliably assess hearing.
If you repeatedly notice limited responses to voices or sounds, describe specific situations to the doctor: was the room quiet, was the child tired, did it happen more than once? Parental observations are useful for discussion, but do not replace assessment. Our guide to the five senses in the first year (French-language article) (French-language article) (French-language article) places hearing within wider sensory development.
Hearing and first words
Language develops gradually, with individual variation. Communication involves voices, but also looks, gestures, facial expressions and touch. A language delay does not prove hearing loss, and an expressive child may still have hearing difficulties. Clinicians consider several aspects rather than relying on one sign.
In France, routine medical examinations continue to assess hearing at different ages, including 4, 9 and 24 months according to Assurance Maladie. Persistent concerns should be raised without waiting for a theoretical milestone. Our article on babies' first words explores communication development in more detail.
Protecting hearing in everyday life
Your home does not need to be silent. Voices, gentle music and ordinary household sounds are part of a baby's environment. It is sensible, however, to avoid speakers placed close to the head, very loud toys and prolonged exposure to high volumes. Do not try to “train” an infant's hearing with powerful sounds.
A baby monitor does not measure the child's hearing. It simply helps an adult monitor the environment according to the device's functions. If you use one, follow the manufacturer's safety instructions, particularly about keeping cables and accessories out of reach. Do not buy a monitoring product expecting it to replace medical screening.
Three everyday scenarios
Scenario one: the first test is inconclusive but the second is satisfactory. The service explains the results and routine follow-up continues. There is no reason to infer a disease from the first attempt alone.
Scenario two: both tests are inconclusive. The baby nevertheless responds to family voices. The specialist appointment remains important, because household reactions are not a substitute for objective assessment.
Scenario three: newborn screening was normal, but months later the parents notice unusual listening responses or a concerning change in communication. The earlier result should not prevent them from seeking advice.
In every situation, the appropriate decision follows the planned pathway and the child's development, not a comparison with social-media videos or other families' stories.
Five questions to ask before leaving the maternity unit
- Were both ears tested?
- What exactly was the result, and where is it recorded?
- Was a second test performed or booked?
- If follow-up is needed, who makes the appointment and by when?
- Who receives the follow-up report and coordinates the next steps?
These questions matter particularly after a short hospital stay, a transfer between services or when you live far from the maternity unit. The CDC describes children being lost to follow-up between screening and diagnosis in the United States. Those statistics should not be applied to France, but the principle is relevant everywhere: an advised appointment needs to happen.
Back at home: keep follow-up manageable
The first days at home can be exhausting. Between feeds, appointments, paperwork and interrupted sleep, a report can easily disappear into a bag. Keep the documents in one place, take a photo of the relevant health-record page if helpful and add the appointment to a shared calendar if you use one. There is no need for a complicated system: a few clearly recorded details can make communication with clinicians much easier.
If a service is meant to contact you, ask when to expect the call and note the number to use if you hear nothing. If caregivers take turns or live separately, make sure the person accompanying the baby has the health record and instructions. If travel is difficult, plan the practical arrangements early rather than postponing the examination. Simple organisation can prevent an important follow-up from being missed.
Understanding the words on the report
You may see “satisfactory”, “response present”, “inconclusive”, “review needed”, “monitor” or the English word “refer”. Wording varies between equipment and services. These terms usually indicate a decision in the screening pathway; they do not, by themselves, describe hearing in full. A technical word photographed on a screen is not a substitute for a professional explanation.
A useful question is: “At this stage, does my baby need another examination, and who will arrange it?” If a term worries you, ask for its definition. The professional can also clarify whether the result concerns one ear, both ears or the overall quality of the measurement. The best report is one that allows the family and the child's doctor to understand what should happen next.
Parental consent and the right to ask questions
Screening is offered after parents receive understandable information. Consent is not merely an administrative formality: it allows families to understand what is being checked, what the test can show and what it cannot. You can ask to see the equipment, find out roughly how long the examination takes or ask why a particular method was chosen. If your baby was admitted to hospital, several teams may have provided information; requesting a clear summary before discharge is entirely reasonable.
A parent may need time to process an inconclusive result. Professionals can explain it without unnecessarily alarming language. One helpful question is: “Do you suspect a condition, or is this simply the next step in screening?” The answer depends on the baby's history, but the question helps prevent premature conclusions. Ask for interpretation or accessible information if needed: medical guidance is only useful when it can be understood.
Families also process information differently. Some want detailed explanations immediately; others first need to know when and where the next appointment will take place. Both are reasonable. The essential information is the same: the result, the next step and how to contact the service. A well-organised follow-up is more useful than a highly technical explanation that leaves parents unsure what to do.
When should you seek medical advice?
Seek advice promptly if screening was inconclusive and no follow-up has been arranged, if your child repeatedly seems to respond very little to sounds, if previously present responses disappear or if communication development concerns you. A family doctor or paediatrician can decide whether specialist hearing assessment is needed. A significant change in an infant's overall condition needs medical assessment according to its severity, independently of the hearing screen.
Key takeaways
Newborn hearing screening is an initial check, not a diagnosis. A “repeat required” result is not a verdict, but it does need follow-up. A normal result is reassuring without removing the need to pay attention to hearing during childhood. The most useful steps for parents are to keep the results, understand the timing and check who is organising the next appointment.
Frequently asked questions
Does the hearing screen hurt?
No. The methods are non-invasive and are usually carried out while the baby is calm.
My baby was asleep. Is the test valid?
Yes. Calmness or sleep can make some measurements easier.
Can parents decline screening?
Screening is offered after information and parental agreement. Ask your care team about the process.
Does “repeat required” mean deafness?
No. Screening cannot establish that diagnosis.
Why is another test needed?
The first measurement may be difficult to interpret. Repeating it helps clarify the situation.
Why check both ears?
Because a hearing difference may affect only one side. The HAS recommends screening both ears.
Does a startle prove normal hearing?
No. A single reaction does not describe the full range of hearing ability.
Should we wait until three months to seek help?
No. Attend the earliest appropriate appointment; three months is a pathway target, not a waiting period.
What if screening was missed?
Contact the maternity service or doctor to arrange catch-up testing.
Are the timelines different for premature babies?
They may be adapted to the baby's circumstances and corrected age.
Can a baby monitor replace screening?
No. It is not a hearing-screening device.
Is a normal newborn screen enough for life?
No. Hearing and communication remain part of ongoing developmental follow-up.
Who performs the assessment after two inconclusive tests?
A specialist, usually within paediatric audiology or ear, nose and throat care.
Does confirmed hearing loss prevent communication?
No. There are different communication approaches and individualised support options.
Sources consulted on 9 October 2026
- Assurance Maladie — Hearing screening and diagnosis in children (16 July 2026).
- Assurance Maladie — Newborn examination in the first eight days (2025).
- HAS — National newborn hearing screening evaluation (June 2025).
- Assurance Maladie — Newborn care at the maternity unit (12 March 2026).
- Occitanie Perinatal Network — Hearing screening.
- Réseau NEF — Hearing screening.
- Paris-region newborn hearing screening coordination — Resources.
- CDC — Can your baby hear you say I love you? (2024).
- CDC — EHDI 1-3-6 Benchmarks (2025).
- CDC — Infants with suspected hearing loss (2024).
General educational information, not a medical diagnosis. Follow the advice of the healthcare professionals caring for your child.
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