In the last two decades, the introduction of newborn screening for hearing loss has dramatically lowered the average age of newborn hearing loss diagnosis to around two to three months of age. The benefits of early diagnosis are manifold, enabling timely intervention and rehabilitation, and, consequently, improved language, cognitive and social development. Interestingly, the reported incidence of sensorineural hearing loss (SNHL) identified through newborn hearing screening varies widely. In this study, Schild et al analyse a cohort of 450 patients from a clinic in the US referred secondary to failing newborn hearing screening. Of these, 72.7% passed their first subsequent hearing assessment (with OAE and/or ABR), and a further 11.1% did so at the second assessment. Overall, 15.7% of infants were born prematurely, 17.6% needed an ITU stay, 0.9% were CMV positive, 3.6% had a family history of SNHL, 2% had in utero infections, 2.4% had craniofacial anomalies, 19.1% had hyperbilirubinaemia, 0.4% were exposed to ototoxic medications, and 0.7% had deafness syndromes. Otitis media with effusion (OME) was diagnosed in 7.8% of patients, and SNHL in 3.8%. Overall, 6% of cases had obstructing cerumen/vernix. Treatment included ventilation tubes in 2.4% of patients, hearing aid fitting or referral in 1.5%, ventilation tubes and hearing aids in 0.9%, soft band/BAHA in one case and cochlear implantation in one patient. Encouragingly, this study emphasises again that the majority of patients referred due to failed newborn hearing screening are subsequently found to have normal hearing. It also highlights that OME and/or cerumen/vernix are a common cause of failed newborn hearing screening, but likely underestimated.