Background: Congenital heart disease (CHD) encompasses heart or blood vessel abnormalities arising during fetal development, affecting around 9 per 1,000 live births annually, totaling approximately 1.35 million infants. CHD is clinically classified as either cyanotic or acyanotic and often coincides with malnutrition and failure to thrive. Infants with CHD are at an increased risk of developing oropharyngeal dysphagia, characterized by difficulties in swallowing. Pediatric nurses play a crucial role in monitoring CHD, including respiratory rates and overall health, with particular attention to assessing nasal flaring for signs of respiratory distress as chest retractions and cyanosis. Objectives: Study aims to Assess variations in respiratory rate across different feeding methods and their impact on neonates with CHD at various time intervals. Methodology: A prospective observational study was carried out at the neonatal unit of Karbala Teaching Hospital for Children in Iraq. Fifty neonates, aged less than 28 days and diagnosed with CHD, were purposively recruited for the study. Inclusion criteria targeted neonates who were undergoing enteral feeding. Results: Analysis of records from 50 neonates revealed significant variations in respiratory rate across distinct feeding periods (p=0.027). and unveils noteworthy variations in nasal flaring throughout distinct feeding periods (p=0.001). And no significant differences in chest retraction across distinct feeding periods (p=1.000), no significant differences between breastfeeding, bottle-feeding and tube-feeding across time intervals of neonates feeding. Conclusions: Respiratory rate demonstrates significant variations across feeding periods. There are no significant differences in respiratory rates before-after feeding among breastfeeding, bottle-feeding, and tube-feeding.