Objective <p>To characterize long-term feeding outcomes in infants who underwent tracheostomy prior to their first birthday.</p> Study design <p>Retrospective review of feeding outcomes at initial hospital discharge and age 5 in a cohort of infants who underwent tracheostomy at a children’s hospital over a 16-year period.</p> Results <p>145 infants met inclusion criteria. In this cohort, 117 were feeding tube dependent at time of initial hospital discharge and 71 were feeding tube dependent age 5. Cardiovascular comorbidities (<i>p</i> = 0.009), long-term tracheostomy dependence (<i>p</i> &lt; 0.001), higher birth weight (<i>p</i> = 0.011), older age at tracheostomy decannulation (<i>p</i> &lt; 0.001) and older gestational age (<i>p</i> = 0.007) were factors associated with feeding tube dependence at age 5.</p> Conclusion <p>The long-term feeding outcomes of infants who require tracheostomy demonstrate high levels of feeding impairment at age 5.</p>