More than two million youngsters caught up in the fighting in Syria are now at risk of malnutrition, according to Save the Children.
In rural Damascus one in 20 children is reported to be severely malnourished.
The charity blames a lack of access to food, soaring prices and a collapse in food production for the growing crisis.
It says it has heard of children surviving on nothing more than lentils or bread for long periods, while a family trapped in their basement lived off half a piece of bread each for four days.
The severe food shortages have been accompanied by soaring prices, with the cost of the most basic supplies having doubled.
Save the Children says lives are at stakeJinan, the mother of a three-year-old, told aid workers: "The price of food doubled in my village and we couldn't afford to eat at all. Milk, bread, everything - doubled.
"The children became very hungry all the time and with no nutrients, they also became sick."
Mother-of-two Maryam said: "Because of a lack of food my children didn't grow as they should. They started losing weight and it was all we could do to keep them alive."
The war has devastated Syria's economy and the United Nations now estimates close to seven million inhabitants have been plunged into poverty.
A Free Syrian Army fighter in AleppoIn addition, Syria's agriculture and infrastructure is collapsing, with grain production falling to less than half of what was typical before the war.
Save the Children chief executive Justin Forsyth said: "The children of Syria have been shot, shelled and traumatised by the horror of war.
"The conflict has already left thousands of children dead and is now threatening their means of staying alive.
"Even if the world cannot agree on how to end the conflict surely they can agree that aid should be able to reach every child in need in Syria.
"There is no room for delay or argument: Syria's children must not be allowed to go hungry."
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