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Background and purpose: Infants with congenital heart disease (CHD) have difficulties with feeding that result in delays in growth and development. Breastfeeding is known to enhance growth and development, yet few infants with CHD are breastfed because clinicians and parents perceive breastfeeding as more difficult and, thus, more stressful to the infant. The purpose of this study was to describe the physiologic response to breastfeeding and bottle-feeding in infants with CHD.Methods: A cross-sectional descriptive design was used. Heart rate and oxygen saturations were collected from 10 infants with CHD following surgical intervention: 5 breastfed infants and 5 bottle-fed infants matched for diagnosis, age at surgery, and number of days post-op at observed feeding. The physiologic data were collected via bedside monitor in 3 phases: 30 minutes prior to the feed, during the feed, and 30 minutes after the feed. Means and standard deviations were measured in each phase for each infant. Groups were compared using t-tests and coefficient of variation calculated using Levene's test of equality of variance. Results: Overall heart rates across the feeding were significantly lower in infants who were breastfed (t = -38.88, p < .001, 95% CI = -8.69, -7.86) with more variability in breastfed infants (F = 2225.24, p < .001). Overall oxygen saturations were significantly higher in infants who were breastfed (t = 55.22, p < .001, 95% CI = 4.78, 5.13) with no differences in variability. Similarly, breastfed infants had significantly lower heart rates and higher oxygen saturations within each phase of the feeding, although heart rates and oxygen saturations were more variable in breastfed infants before and during feeding and less variable after the feeding compared with bottle fed infants. Conclusion: Breastfed infants demonstrated more physiologically supportive responses to feeding compared with bottle fed infants. These findings suggest that breastfeeding may be less physiologically stressful to infants with CHD. However, the sample size was small and additional research is needed. Healthcare clinicians need to support and encourage breastfeeding in this population.