Introduction: To promote the growth and development of infants hospitalized at intensive care units, (NICUs) appropriate care should be provided. Improper care leads to various problems in infants, such conditions that endanger their growth and development. Therefore, this study aimed to explore the challenges of caring at neonatal intensive care units.

Methods: An exploratory and descriptive qualitative study was performed. Participants included five mothers and 25 nurses working at the NICU`s of teaching hospitals affiliated to Isfahan University of Medical Sciences. Purposive sampling was conducted until data saturation. Data was collected through unstructured interviews and field-work. All interviews were recorded, transcribed verbatim and analyzed line by line. Conventional content analysis was used for data analysis.

Results: The challenges of care at the NICUs emerged to four themes and ten categories, including: 1. Interactions (professional, family, and interactions with the infants), 2. Ccare (routine-orientation, understanding the need for the developmental care and conflict between traditional care and developmental care), 3. Structure of the NICU (deficit of the structural standards and equipment, survival or death) 4. Nurses’ competence (inadequate expertise and unsuitable employment).

Conclusions: Care at the intensive care unit for newborns, has always faced challenges. According to the findings of this study, health care centers must plan and implement measures such as physical structure and standards at the NICU, implement of developmental care strategies and provide proper care by qualified nurses.