How can I tell if my newborn is actually in pain?

Mama was right

Papa kept picking Ari up whenever she groaned or cleared her throat. Mama said to wait. Mama was right.

The slightly painful realisation came afterwards: many times Ari had been asleep, made one of her normal noises, and Papa had helpfully woken her up. Then Ari was tired but wide awake, while Papa slowly lost his mind trying to settle her again.

Newborn sleep is unbelievably noisy

Babies grunt, sigh, fidget, pull faces and clear normal secretions while still asleep. The sound alone does not tell you they are in pain.

We learned to watch her colour, breathing and what happened next. If she settled again without help, the noise had usually been part of sleep rather than a request for rescue.

Waiting is not ignoring

Our fear underneath all of this was choking, especially after NICU alarms had trained us to react. We settled on pausing briefly before reaching in while still watching her properly.

A cry that is weak, unusually high-pitched or genuinely different, colour changes, breathing difficulty, being hard to wake or refusing feeds are not ‘wait and see’ noises. Those need help.