All children in Syria's battered Aleppo are suffering from trauma after enduring some of the worst violence in their country's war, the UN children's agency said on Sunday.
"All children in Aleppo are suffering. All are traumatised," Radoslaw Rzehak, UNICEF's field office head in Aleppo, told AFP inside the devastated city.
"I have never seen in my life such a dramatic situation (as) what is happening to children in Aleppo," said Rzehak, who has been working for UNICEF for the past 15 years.
Tens of thousands of children in Syria's northern city have borne witness to one of the bloodiest phases of the country's nearly six-year war.
Rzehak estimated that half a million children in Aleppo need some kind of psychological and social support, including 100,000 who need more specialised assistance.
The city's east had been a rebel stronghold since mid-2012, but government forces in recent weeks have overrun more than 85 percent of that area.
An estimated 120,000 people have fled the city's east, many heading towards displacement centres in government-controlled areas to the west.
Rzehak said preliminary psycho-social assessments at these centres showed children from east Aleppo were "losing their basic instinct of defence."
"Some of the children who are five, six years old, they were born during a time when war was already happening. All they know is war and bombing," he said.
"For them, it's normal that they are being bombed, that they have to escape, it's normal that they are hungry, that they have to hide in the bunkers. This trauma is going to last for a very, very long time."
He said this was putting children at risk, as they have not been conditioned to take cover or hide during bombardment.
"For them, this is not danger. This is every day life."
West Aleppo's children, meanwhile, had been severely impacted by seeing classmates or teachers killed in rocket attacks on their schools.
"The place that was the most secure for children became the place where they die," Rzehak said.
The war has even undermined the ability of parents to care for their children as they struggled with their own trauma.
"It's very difficult to blame them. They also went through the nightmare," Rzehak said.
More than 300,000 people have been killed since Syria's conflict erupted in March 2011, and millions more have been forced to flee their homes.