Multiple studies have indicated that children with congenital heart disease (CHD) have a high incidence of oral feeding difficulties, failure to thrive, and difficulty maintaining adequate nutritional intake.   In the past decade, advances in surgical techniques and technology have resulted in most children receiving palliative or corrective surgery for their CHD in the first year of life.  Literature indicates that a large number of infants experience difficulty with feeding and nutritional intake postoperatively and that this is a key factor in prolonged critical care and overall hospital length of stays following cardiac surgery.  Although nutrition and feeding difficulties have been identified as key management issues in the care of these children during their peri-operative hospital stay, there has been no research performed at this institution examining patient characteristics or patient outcomes in relation to feeding or nutritional difficulties.  The institution lacks formalized evidence-based clinical guidelines to direct the care of patients with congenital heart disease in relation to feeding and nutritional difficulties during the peri-operative period.  The feeding and nutritional outcomes of infants undergoing cardiac surgery from 2001-2006, at our institution, were reviewed retrospectively. Standardized evidence-based clinical guidelines were developed based on this review, current literature and research and collaboration with experts in other centers. Patient outcomes post-implementation of these guidelines will be measured and reviewed.