Newborn hearing screening in Colombia
- Topic
In Colombia every newborn has the right to a free hearing test; the goal is to screen by 1 month, diagnose by 3 months and intervene by 6.
What it is
Congenital hearing loss cannot be seen on physical examination: a deaf newborn may babble and turn the head to vibration or visual cues, and without screening the diagnosis often comes after the first birthday. In Colombia, Law 1980 of 2019 requires hearing screening for every live newborn, and Ministry of Health Resolution 207 of 2024 sets out how to do it using the 1-3-6 principle: screening no later than 1 month, audiological diagnosis no later than 3 months and intervention no later than 6 months. This page summarises the rules, the tests and what to do when a baby does not pass the screen.
Key facts
- Rules checked on the official websites on 2026-11-05.
- Law 1980 of 2019 (Diario Oficial 51.026, 26 July 2019) creates the Newborn Screening Programme; its purpose includes early detection of congenital blindness and deafness (article 1).
- Article 3 of Law 1980: the Ministry of Health, through the health system, guarantees every live newborn basic, hearing and vision screening.
- Article 12 of Law 1980: health staff inform the father, mother or legal representative of the newborn about the purpose and consequences before the procedure.
- Resolution 3280 of 2018 (Health Promotion and Maintenance Pathway) lists hearing screening of newborns without risk of hearing loss among the interventions to be phased in (article 4, compiled text).
- Resolution 207 of 2024 (Diario Oficial 52.669) adopts the programme's technical and operational guidelines (Technical Annex 1), with a hearing screening line that complements Resolution 3280.
- Resolution 117 of 2026 extends metabolic screening with six new tests; the Ministry reaffirms the four components: vision, hearing, critical congenital heart disease and endocrine-metabolic.
- Colombian guideline on congenital anomalies (Guideline No. 03, 2013): universal screening with OAE or brainstem response after 24 hours of life or before discharge.
Step by step
- Inform the parents and obtain their consent before the test (Law 1980, article 12).
- Check risk factors for hearing loss: they decide whether one test is enough or OAE and AABR are done together.
- Screen after 24 hours of life or before discharge, and no later than 1 month of age.
- If the baby fails, repeat the screen no later than 1 month; an abnormal result is a probable case.
- Refer the probable case for a full audiological assessment with objective tests before 3 months.
- Confirmed hearing loss: start intervention (hearing aids, implant, speech and language therapy) before 6 months.
- With a normal screen and risk factors, plan hearing and language follow-up through early childhood.
The two newborn hearing screening tests
| Test | What it assesses | Key limitation | When it is used |
|---|---|---|---|
| Otoacoustic emissions (OAE) | Outer ear, middle ear and the outer hair cells of the cochlea | Affected by ambient noise, middle-ear problems or wax; does not assess the retrocochlear pathway | Healthy newborn without risk factors (or first test in a two-step sequence) |
| Automated auditory brainstem response (AABR; RATEA or PEAA) | The whole pathway up to the brainstem, including the neural part | Uses scalp electrodes; like OAE, it detects losses from moderate upwards (30 to 40 dB) | Preferred for all babies under Resolution 207; required with risk factors |
| Both in parallel | Cochlea and retrocochlear pathway | Sensitivity 96 % with lower specificity (89 %) in the guideline | Risk factors or neonatal unit stay: abnormal if either test fails |
In clinical practice
- Risk factors listed by Resolution 207: family history of deafness, prematurity, low birth weight, craniofacial or ear malformations, syndromes such as Down or Goldenhar.
- Also: meningitis or central nervous system infection, hyperbilirubinaemia needing phototherapy or exchange transfusion, perinatal hypoxia, neonatal ICU stay with oxygen and maternal exposure to ototoxic drugs.
- Congenital infections that call for hearing surveillance: cytomegalovirus, rubella, toxoplasma, syphilis, herpes and HIV; Resolution 207 adds suspected Zika or chikungunya.
- With risk factors OAE alone are not enough: they do not assess the retrocochlear pathway, so Resolution 207 asks for OAE and AABR combined.
- Physical examination is insensitive for hearing loss: without screening, congenital deafness is usually found late, often around school entry (2013 guideline).
Next step / Initial management
- First step: record in the notes the result for each ear, the test used and the risk factors.
- Abnormal screen (probable case): repeat no later than 1 month and refer as a priority to paediatric audiology for diagnosis with objective tests before 3 months.
- Confirmed hearing loss: refer to ENT to look for the cause and to rehabilitation (amplification, speech and language therapy) so that intervention starts before 6 months.
- Normal screen with risk factors: specific hearing follow-up under Resolution 207, with referral to audiology if any doubt arises.
- Normal screen without risk factors: routine development and language follow-up within the Health Promotion and Maintenance Pathway.
Test yourself
Think of the answer, then tap the question to see it.
A healthy term newborn passes screening with otoacoustic emissions. Which part of the auditory pathway was not assessed?
The retrocochlear pathway (auditory nerve and brainstem). OAE reach only the outer hair cells; that part needs auditory brainstem response testing.
What does article 3 of Colombia's Law 1980 of 2019 establish about newborn screening?
That every live newborn receives, progressively, mandatorily and free of charge, at least basic, hearing and vision newborn screening.
A preterm baby who was in the neonatal ICU on oxygen is about to be screened. Which tests are recommended and how are they read?
Otoacoustic emissions and automated auditory brainstem response together, in parallel: the result is abnormal if either fails and normal only if both pass.
An infant failed the hearing screen and the repeat at 1 month. By what age should the audiological diagnosis be confirmed?
No later than 3 months of age, with a full audiological assessment; if hearing loss is confirmed, intervention should start no later than 6 months.
Connections
Educational content; it does not replace a medical assessment and is not a clinical instruction. For a real case, follow current guidelines and specialist advice.
Sources: Ley 1980 de 2019, por medio de la cual se crea el Programa de Tamizaje Neonatal en Colombia (Congreso de la República de Colombia (compilación normativa de la Superintendencia Nacional de Salud), 2019); Resolución 207 de 2024: lineamientos técnicos y operativos del Programa de Tamizaje Neonatal (Ministerio de Salud y Protección Social (compilación normativa de la Superintendencia Nacional de Salud), 2024); MinSalud amplía el tamizaje neonatal (Resolución 117 de 2026) (Ministerio de Salud y Protección Social, 2026); Resolución 3280 de 2018: Ruta Integral de Atención para la Promoción y Mantenimiento de la Salud (Ministerio de Salud y Protección Social (compilación normativa de la Superintendencia Nacional de Salud), 2018); Guía de práctica clínica: detección de anomalías congénitas en el recién nacido (Guía No. 03) (Ministerio de Salud y Protección Social; Colciencias, 2013); Measurement of Timely Screening, Diagnosis, and Intervention (EHDI 1-3-6) (Centers for Disease Control and Prevention, 2024).
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Representative model, for educational purposes only.