The purpose of this randomised control trial is to determine the efficacy of CT-optimal touch (gentle stroking at 3cm/s) for newborn's who require a heel prick.

Newborn infants are subject to several novel experiences that cause physiological, biochemical and behavioural indicators of stress; even routine and common events such as handling, changing a diaper or being bathed can increase salivary cortisol levels. Excluding surgery and mechanical ventilation, the most common procedural pain sources in newborns are heel-lancing and venepuncture. Tactile interventions such as skin to skin care and 'still containment hold' are widely used in clinical care with apparent positive results such as lower mean respiratory heart rate and pain measures, and higher oxygen saturation; yet, dynamic touch interventions have reported to be more beneficial than static touch interventions.

A distinct type of nerve fibres, CT (C tactile) afferents, found exclusively in hairy skin, that respond optimally to gentle stroking at a velocity of ~1-10cm/s, are part of a system for processing pleasant and social rewarding touch. CT fibre activation also plays a role in pain inhibition and may be linked to the development of self-regulation, thereby, serving a neuroprotective function for the developing infant brain. Here we will investigate whether tactile stimulation at CT-optimal velocity will reduce biochemical and physiological indicators of stress in infants, as determined by salivary cortisol, heart rate and blood oxygenation levels.

Inclusion Criteria:

• The infant is born between 35 and 42 weeks.
• Require a heel prick
• Infants may be treated with antibiotics.
• Infants may be supported with non-invasive respiratory support.
• Infants may require blood sugar monitoring.
• Infants may be monitored for jaundice or infection.
• Written consent has been obtained from the person(s) with parental responsibility.

Exclusion Criteria:

• Have a history of neurological problems.
• Receiving pharmacological analgesics.
• Known genetic condition.
• Breastfed babies
• Admitted to high dependency or intensive care
• Invasive respiratory support
• Receiving parenteral nutrition
• Has received any treatment for seizures
• Clinical instability in the judgment of nurses/midwives and paediatricians looking after the baby and mother.

Allocation sequence will be randomised in advance by a trusted member of LJMU staff who is not involved in the study, using a computerised website to generate random numbers. The sequences will be placed in sealed opaque envelopes and stored in a secure location on-site. The use of an off-site computerised system for group allocation will decrease the risk of allocation bias. Eligible infants whose person(s) with parental responsibility have provided consent will be assigned the next available envelope which will be accessed by the lead researcher prior to the intervention.