A pilot randomized clinical trial to assess whether magnetic acupuncture reduces pain prior to painful procedures (heel prick) in neonates by comparing changes in cortisol levels and pain scores.

The magnetic acupuncture (MA) stickers (Sakamura, Helio Acupuncture, Japan) will be applied bilaterally in both ears to the five auricular acupuncture points as per the Battlefield Acupuncture (BFA) at least 30 minutes prior to a heel prick by the unblinded investigator. The BFA protocol has been used in both adults and children for management of acute pain conditions. All unblinded investigators administering the intervention will complete a one-hour BFA workshop delivered by experienced BFA practitioner, All infants will receive standard care including sucrose prior to heel prick per local NICU guidelines; additional analgesic measures remain at clinical discretion. Stickers will remain in place for a maximum of three days or just prior to discharge from the neonatal unit, when they will be removed. Each infant will be followed up for the duration of the MA or placebo intervention, and stickers will be checked every eight hours by bedside nurses. The magnets have a strength of 100G and measure 1.7 mm in diameter on a circular sticker of surgical tape with diameter 10 mm. These magnets have already been used for pain management in the neonatal population with no side effects reported.