Two million children have become the "forgotten victims" of the bloody conflict in Syria, according to Save the Children.
As the conflict enters its third year, children are increasingly being used by fighters as human shields, runners and porters, putting them on the frontline. Others are suffering malnutrition, disease and homelessness.
According to the Childhood Under Fire report by the charity, one in three children has been hit, kicked or shot at, while three in four have lost a loved one.
A boy digs a cave to be used as a shelter from fighting Justin Forsyth, Save the Children's chief executive, said: "For millions of Syrian children, the innocence of childhood has been replaced by the cruel realities of trying to survive this vicious war.
"Many are now living rough, struggling to find enough to eat, without the right medicine if they become sick or injured.
A rebel fighter with her daughter at their Aleppo home "As society has broken down, in the worst cases, hunger, homelessness and terror have replaced school for some of these young people.
"We cannot allow this to continue unchecked; the lives of too many children are at stake."
Childhood Under Fire, launched to mark two years of fighting in the Middle Eastern country that has claimed 70,000 lives, says many children are struggling to find enough to eat.
A father with his daughters who were injured in the fighting Thousands are living in barns, parks and caves and are unable to go to school because teachers have fled and schools have been attacked.
Young boys are also being used by armed groups as porters, runners and human shields, bringing them dangerously close to the frontline, it warns.
Girls are being married off early to ensure that they have someone who can protect them from sex attacks.
Parents and their children flee across the border to Turkey The report is released ahead of talks in London between Foreign Secretary William Hague and his Russian counterpart Sergei Lavrov, which are likely to be dominated by the conflict.
The charity urged the international community to push for an end to the violence that has torn Syria apart.
It is planning to hold vigils in 21 countries on Thursday to mark the second anniversary of the start of fighting in the country.
A boy watches as graves are dug for future victims of the conflict The prospects for peace currently look dim. Last week Mr Lavrov said there was "absolutely" no prospect of Moscow urging Syrian president Bashar Assad to stand down.
Mr Hague announced that Britain would send armoured vehicles and body armour to Syrian opposition forces as it steps up efforts to end a humanitarian crisis of catastrophic proportions.
Save the Children said that $1.5bn (£1bn) pledged in aid needs to be delivered to those suffering in the country and in refugee camps in neighbouring countries, with some areas still not having received any foreign aid.
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