The number of children dying from abuse could be much higher than previously thought, according to the NSPCC.
The NSPCC believes some cases are being missed
The charity believes that some deaths may be going unnoticed because cases are not being tracked properly.
It has called for a new national system to enable doctors, social workers and other professionals to gather information on possible abuse cases.
The NSPCC has also called on the government to ensure every child death is investigated fully.
At present, doctors only declare that a child has died as a result of abuse if the evidence is overwhelming.
In many cases, they will only make such a verdict if there are clear signs of abuse or if the abuser has confessed.
The NSPCC wants doctors, social workers and other professionals to be able to gather and share information about possible cases of abuse.
In a report it says such a system would enable doctors to identify those children who are killed by abuse much more easily.
A survey of 121 paediatricians by the charity found that three out of four believe the monitoring of children at risk needs to be a higher priority.
Three out of five said they needed better training to identify children at risk.
The charity also called for child death liaison officers in every hospital to gather information from staff and families when a child dies.
Procedures should be extended to take account of the relationship between the child and their carer, it said.
Doctors were most often alerted to child abuse by parents or carers changing their stories, or by unusual bruises, the report found.
The death of another child in the family was also a factor in alerting doctors.
"Judging whether or not a child has ended up in hospital as a result of abuse is difficult," said Corinne May-Chahal, who wrote the report.
"Medical professionals dealing with child deaths are faced with tough decisions, often based on fragmented information.
"In an increasing climate of litigation they are becoming reluctant to identify child maltreatment, even when they believe it is probable."
Mary Marsh, NSPCC chief executive, called on the government to make it easier for professionals to identify children who had been abused.
"The government needs to introduce a national standard for collating information relevant to child deaths as a result of maltreatment, as a matter of urgency.
"Without such information, cases of children who die as a result of maltreatment could be missed and their siblings left at risk."