Published: 2020-03-21

Randomized control trial evaluating the effectiveness of ear plugs in hearing loss in NICU preterm babies

Fathma Thahmi Shingeri, Ashvij R. Shriyan, Roshan Ann Maben, Santosh T. Soans


Background: The prevalence of hearing loss is higher in neonates admitted to NICU compared to the general population. Preterm babies are more vulnerable to the hearing damage due to their immature inner ear exposing them to various high frequency noises in the NICU to which they were not accustomed. Most NICU in India exceed the recommended sound levels. In order to reduce damage to the ears, foam-based earplugs are used to reduce the sound intensity reaching the ears of these premature babies.

Methods: Babies admitted to NICU are allocated alternatively to receive earplugs or not. Cases are preterm babies with earplugs and controls are the ones without earplugs. The incidence of hearing loss is found by OAE testing of the ears at the end of NICU stay.

Results: Out of 40 in each group, 6 babies in control group failed the OAE compared the 3 in the earplug group. Babies who did wear earplugs had longer period of NICU stay.

Conclusions: Use of earplugs in babies admitted to NICU reduced the incidence of hearing loss and also length of NICU stay.



Hearing loss, Neonatal intensive care unit, Preterm babies, Otoacoustic emissions

Full Text:



Sá MM, Azevedo R, Neves J, Machado O, Tavares J. Noise in an Intensive Care Nursery/Newborn Unit. J Health Educ Res Dev. 2018;6(265):2.

American Academy of Pediatrics Committee on Environmental Health. Noise: a hazard for the fetus and newborn. Pediatrics 1997;100:724-7.

Joshi G, Tada N. Analysis of noise level in neonatal intensive care unit and post natal ward of a tertiary care hospital in an urban city. Intern J Contemp Pediatr. 2016;4(3):1358-61.

Davis A, Wood S. The epidemiology of childhood hearing impairment: factors relevant to planning of services. Bri J Audiol. 1992 Jan 1;26(2):77-90.

Carvalhais C, Santos J, da Silva MV, Xavier A. Is there sufficient training of health care staff on noise reduction in neonatal intensive care units? A pilot study from neonoise project. J Toxicol Environ Health, Part A. 2015 Jul 18;78(13-14):897-903.

Bremmer P, Byers JF, Kiehl E. Noise and the premature infant: physiological effects and practice implications. J Obstetr, Gynecol, Neon Nurs. 2003 Jul;32(4):447-54.

Almadhoob A, Ohlsson A. Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants. Cochrane Data System Rev. 2020(1): CD010333.

Turk CA, Williams AL, Lasky RE. A randomized clinical trial evaluating silicone earplugs for very low birth weight newborns in intensive care. J Perinatol. 2009 May;29(5):358-63.

Abujarir R, Salama H, Greer W, Al Thani M, Visda F. The impact of earmuffs on vital signs in the neonatal intensive care unit. J Neon-Perin Med. 2012 Jan 1;5(3):249-59.

Yojana Parmar. A Study to Assess the Impact of Earmuffs on Physiological Parameters in Neonates inNeonatal Intensive Care Unit. Intern J Health Sci Res. 2018; 8 (9):115.

Litton E, Elliott R, Ferrier J, Webb SA. Quality sleep using earplugs in the intensive care unit: the QUIET pilot randomised controlled trial. Criti Care Resus. 2017 Jun;19(2):128.