At our hospital we have 2 small hearing test machines.  We take them room to room and do our tests.  There are still those nurses who feel they must do everything for the baby at the nurses desk/nursery (we really dont have a nursery except for a sick baby and only 1-2 beds), but the majority will do it at bedside.  And yes I often times will tell a mom to call me with a feed and I will do the one side thats up and then she will call me when she nurses on the other side.  I have not had a problem doing it this way and very often its the best way to get a "pass" on the test.

If the baby is a difficult latcher or having problems breastfeeding then I dont do this.  Sometimes when I am trying to put the probe in the babies ear he will detach with distraction or discomfort and that is very upsetting to me and the mother after we have worked at a latch.  I will have mom or dad put a finger in the babies mouth instead and that works as well.

We dont have any pacifiers on our unit.  And it doesnt seem to be an issue.  The nurses who are the least supportive of family centered care and breastfeeding, either because of personal philosphy or they are new and havent come around, will sit at the desk with the child and use a gloved finger if necessary.  (I know this practice can set the baby up for latex allergies later and its something to work on).

The only time our hearing tests dont "take" is when the ear canal is full of vernix or fresh bathwater and then we just wait a few more hours and try again, or try to clean/dry the canal a little.  Our machine works by multiple puffs of sound or vibration that is directed at the ear drum and so must be unhindered as it travels down the canal.  It takes a minute or two to complete the test.

I have worked other places that the hearing test was a series of high pitched whistles etc.  That one was more difficult to use, but I also did it while the mother was breastfeeding.  In fact the audiologist demonstrated it to us 4 years ago while the mom was nursing.

Hope this helps
Theresa Johnson RNC IBCLC
Orlando Florida


Barb Fibich <[log in to unmask]> wrote:
Hi everyone,

I've been a lactnet "lurker" for the past few months and have really
appreciated all of the thoughtful posts. I'm learning so much from all of
you.

I wanted to comment on the pacifier with hearing test issue. In Wisconsin,
all babies are supposed to have a hearing test before discharge. We had
the same problem with pacifiers being left behind in the cribs and going
back to the rooms with baby. Although it didn't make us very popular, we
were able to get our supervisor to support removing the pacifiers from the
unit. The nurses can still get them from distribution, but usually by the
time distribution gets one sent up, the problem is solved and everyone
forgot who it was for in the first place.

We've had good luck with teaching the moms to call us when the baby is in a
deep sleep and getting the test done then. I know of another hospital in
the state that has a machine that they take from room to room, so the test
can be done with the babe in his/her mother's arms. It's definately a
challenge to change staff thinking on this one, but we found that having a
baby who was vigorously sucking on a pacifier made it hard to accomplish
the test anyway. Once people made that connection, they were less likely
to cuss us out. (Either that or they save their swearing for after we leave
the unit!)

Good Luck!
Barb Fibich, RN, CLC
Froedtert Hospital
Milwaukee, WI

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