Nearly two million civilians were without water in the devastated northern city after regime bombardment damaged a pumping station and rebels shut down another in retaliation, the United Nations said.
Rebel-held districts in east Aleppo came under intense air and artillery fire for a fifth night as the army prepared a ground offensive to recapture the whole of the divided city.
Syria's main opposition coalition denounced the "silence of the international community", saying Damascus and its Russian allies were committing "a crime" in Aleppo.
"We were home when a missile crashed into our road," said one resident of the Bab al-Nayrab district who gave his name as Nizar.
"Half of the building just caved in and our baby was hit on the head. He died on the spot," Nizar said, the body of his son on the ground wrapped in a blanket.
Seven people were killed in a strike as they queued to buy yoghurt at a market in the Bustan al-Qasr district on the front line dividing the government-held west from the rebel-held east of the city.
Medics said they were carrying out many amputations to try to save the wounded, while supplies of blood and IV drips were running out.
On Friday, at least 47 people were killed in heavy bombing, among them seven children, the Observatory said.
There was massive destruction in several neighbourhoods, including Al-Kalasseh and Bustan al-Qasr, where some streets were almost erased by the bombardment.
Residents and activists said one type of bomb had produced earthquake-like tremors upon impact, razing buildings right down to their basements where many residents desperately seek safety during attacks.
The group says it has just two fire engines left for all of east Aleppo which, and like its ambulances, they are struggling to move around the city.
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