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Regime aircraft and artillery pounded the rebel-held southern neighbourhood of Sheikh Said as Damascus and its ally continued a renewed offensive since Russia declared an end to a month-long humanitarian pause on Tuesday.

The more than 250,000 civilians living under siege in the east of the city spent the night in basements and bomb shelters with strikes resuming in the early hours.

The rebels retaliated by firing more than a dozen rockets into government-held areas of the city, monitoring group Syrian Observatory of Human Rights said.

Airstrikes and shelling on Thursday killed at least 25 people and hit a water pumping station, while Wednesday's bombardment hit a children's hospital and the city's blood bank.

No UN agency has reached east Aleppo since July and aid agencies have warned food, fuel and medical stocks will run out this week.

"There is only enough to keep the bakeries going to give people at least some bread. People are only getting about 15 percent of what they need," Brita Hagi Hassan, president of the city council for rebel-held Aleppo, told Reuters.

Russian Foreign Minister Sergey Lavrov and US Secretary of State John Kerry discussed Syria on Thursday in their first meeting since Donald Trump's presidential election.

Kerry said it was a "constructive, important" conversation.

Meanwhile Lavrov claimed Russia's bombing of Idlib and Homs provinces was to prevent Islamic State militants retreating Iraq's Mosul from entering Syria - despite only Homs province sharing a border with Iraq, though still some hundreds of kilometres from IS-held Mosul.