Doctors treating thin and bedraggled youngsters say a lack of nutritious food and clean water are threatening lives among the 250,000 children still in relief camps nearly three months after the catastrophic floods began.

With much of southern Sindh province still under water and many temporary camps in schools closing to allow classes to resume, the future for children of the flood is worrying, they say.

"These children are facing serious threats to their lives. Malnutrition is posing a huge threat and could cause a greater disaster," said Mohammad Ashraf, a nutritionist from Hyderabad volunteering in the relief camps.

The UN children's agency, UNICEF, said aid agencies and state authorities have been targeting more than 75,500 severely malnourished children who are 10 times more likely to die because of lack of decent food.

Another 180,000 moderately malnourished children are in need, they said, aggravating an already dire situation for Pakistan's impoverished families.

"The floods have aggravated malnutrition among children who were already suffering and have spectacularly exposed the situation before the world," said Kaleem Shaikh, head of charity, the Peoples Development Foundation.

In the last mass nutrition survey conducted in 2002, Pakistan health authorities said that about 40 percent of children under the age of five were underweight and stunted.

Three-week-old twins Bilawal and Bakhtawar -- named after the children of assassinated former prime minister Benazir Bhutto -- looked pale and gaunt as their mother sat in a tent to nurse them in Karachi's western suburbs.

"They are ill. Their bodies are shrinking but nobody is here to take care of us," said their mother Nazeeran Bibi, 38.

"They depend on my breastfeeding but how can I feed them? I don't have any proper food to eat," she said, holding them wrapped tightly in cloth to keep them away from the sun's scorching rays.

UN figures show that nearly three million children under the age of five were affected by the floods, which began at the end of July, and a rough UNICEF estimate shows 250,000 are still critically affected by a lack of food.

As the season cools and winter rains arrive, UN officials at the World Food Programme said that stockpiling food is an urgent issue.

"Rapid assessments of nutritional status and clinical observations strongly suggest that rates of acute malnutrition are rising," said WFP spokeswoman Jackie Dent.

But she said donations to UN funding appeals had been desperately slow and threatened the emergency operations.

"Sadly, we are getting low on funds and by November we have a pipeline break for several commodities," said Dent, adding that more than 80 million dollars were needed for provisions in November and December alone.

Shama Khoso, 28, fled her home with her peasant husband and four children a month ago when their house in the town of Garhi Khero in northern Sindh was completely submerged by torrential waters.

She said all her children have fallen ill after the family were forced to move between relief camps to find shelter, with food still scarce at the field camp in Hyderabad where the family now resides.

Her youngest daughter, 15-month-old Samina, has been staying in the hospital for a month but shows no sign of improvement, Khoso said.

"We often get food just once a day, sometimes twice. My children eat rice whenever it is distributed but they don't get any milk," she said.

Doctors say a combination of malnutrition and dirty drinking water have caused skin problems, diarrhoea, malaria and respiratory problems for children, particularly those under the age of five.

UNICEF's Sindh head Andro Shilakadze said the agency is busy planning for winter with the arrival of blankets and the building of new temporary camps to house those being evicted from camps based in schools.

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