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"The situation in Gaza is deteriorating quickly and we are deeply concerned about the physical, and also psychological impact that the current violence is having on children and families," said Jennifer Moorehead, Save the Children's Occupied Palestinian Territory Country Director.

Protests on Monday saw many more people injured and killed.

Eight-month-old Leila al-Ghandour died after suffocating from tear gas, east of Gaza City, during the border protests on Monday.

She was one of the youngest victims in the six-weeks of bloodshed that has seen Israeli snipers open fire on crowds of protesters.

It was not immediately clear how close to the border fence baby Leila and her family were. The health ministry said at least 60 Palestinians were killed by Israeli snipers. 

There were also worrying reports that a 14-year-old was among the reported five children killed on Monday.

The ever-rising number of casualties in Gaza is having a devastating impact on children. At least 600 children have been hospitalised so far,  from the Palestinian ministry of health in Gaza.

The total number of injuries of all protesters has now reportedly  with around  requiring hospitalisation. The sheer volume of wounded has left medical workers struggling to keep pace and has pushed services and families to breaking point.

With fresh violence at the protests in Gaza expected on Tuesday - and the possibility of the violence spreading to Jerusalem and the West Bank in the coming days - even more children may be exposed to an increased risk of violence, the human rights group has said.

There are dozens of cases of children suffering extreme injuries. These include having to have limbs amputated or have had their bones shattered by shrapnel or live ammunition. Some have been hit in the torso, face, neck and head.

"Already more than ten children have been killed and a thousand have been hurt, many suffering from life changing injuries," said Moorehead.

"According to the ministry of health in Gaza, there are dozens of cases of children suffering extreme injuries. These include having to have limbs amputated or have had their bones shattered by shrapnel or live ammunition. Some have been hit in the torso, face, neck and head. The effect this is having on the children and their families cannot be overstated."

— Save the Children UK (@savechildrenuk) " style="color:#fff;" class="twitter-post-link" target="_blank">Twitter Post At least 250 children, some as young as eight years old, have been shot by live ammunition in the Gaza protests >> Watch and share Rashed's story. — Save the Children UK (@savechildrenuk)

According to data from an inter-agency protection working group at the start of the week, almost  are believed to require psychosocial support, a figure which rises after every wave of protests.

"Families are already suffering the consequences of a ten-year-blockade and three wide-scale conflicts. They are struggling to cope with severely injured and distressed children who are only able to receive limited medical support. It's truly heart-breaking," Moorehead said.  

"Parents of those who have been injured tell us they don't know how to support their children, while children are telling us that the violence is making them feel hopeless, insecure and afraid. A 14-year-old boy who was badly wounded in both legs told us he felt he would go 'crazy' after learning that he would not be able to walk for two years because of his injury."

An  by Save the Children and Palestinian aid group MAAN Development Centre, found that out of 500 injuries to children for which detailed information was obtained, 250 children (almost 50 percent) had been hit with live ammunition.

The EU, UN's secretary general, as well as aid agencies and the UN High Commissioner for Human Rights  that excessive force was used in response.

 Antonio Guterreshas called for an independent investigation to be carried out into the massacres. 

Read also: No Israelis were harmed in the making of this massacre

Gaza has been under a ten-year blockade by Israel that has hit almost all aspects of daily life - from education and employment to health and sanitation.

The stalled reconciliation process between the Palestinian Authority that governs the West Bank and the de facto authority in Gaza have further deepened the economic and social distress of children and their families in Gaza.

Power cuts across Gaza and salary cuts of thousands of PA employees, are also frequent.

A general reduction in donor assistance and the pending cuts to the UNRWA budget have further exacerbated woes.

"At a time when families' needs are only getting higher, the international community must step up and to do more to assist the people and families of Gaza. Despite this, funding is lower than it has ever been at this point in the year," Save the Children's Moorehead said.

"We strongly urge all protests to remain peaceful, and call on all sides to tackle the long-term causes of this conflict and promote dignity and security for both Israelis and Palestinians," Moorehead added. 

"In line with international humanitarian and human rights law, we are also calling for an end to this long-standing blockade, as lifting it will be essential to achieve any sustainable solution and establish a durable peace, reconstruction, recovery, and longer-term development."