For the first time since 2013, the Obama administration is coming under pressure to consider coercive/military options in Syria to stop the indiscriminate assault on besieged eastern Aleppo and to give leverage to stalled cease-fire diplomacy with Russia. The administration is worried that even limited action, such as cruise missile strikes on regime aircraft that violate the cessation or bomb UN aid convoys, could lead to a possible escalation with Russia, so they are proceeding cautiously. They also are still hoping the Russians will come back to them with ideas for how to revive the cease-fire. But the intense regime/Russian bombing of eastern Aleppo and large-scale loss of life — and the prospect of more — is putting the administration under the most serious pressure since the 2013 chemical weapons attacks to consider coercive/limited force options to restrain regime atrocities and try to get the cease-fire agreement back on track.

“Given what we have seen in the ground and in the air, around Aleppo, unless something dramatically changes very, very soon … we are going to have to take those steps to suspend our bilateral engagement on Syria,” Kirby said. “That is not an insignificant move for us.”

The warning, made in a phone call by Secretary of State John Kerry to his Russian counterpart Sergey Lavrov Sept. 28, comes as the State Department said nondiplomatic options are being discussed for dealing with the mounting loss of life in the Russian and Syrian air assaults on Aleppo. But US officials stressed they still consider a diplomatic solution that would restore the Syria cease-fire deal and get the Syrian parties into political talks in Geneva their preferred option.

WASHINGTON — In what would mark a dramatic shift of policy from the international diplomatic effort it has pursued the past year, the United States warned Russia Sept. 28 that it will suspend US-Russian engagement on Syria if Russia does not take immediate steps to halt a Russian-backed Syrian regime assault on rebel-held eastern Aleppo that has killed 96 children since Sept. 23, according to United Nations agencies.

If Russia does not take significant steps in the coming days to ground the Syrian air force over Aleppo, the United States will likely pull its technical teams in Geneva home, among other steps, while it considers how to adjust its policy, Kirby said. Washington may announce it is recalling its teams to Geneva and Amman involved in overseeing a March US-Russia Syria cessation of hostilities agreement as early as Sept. 29.

“There are other options that don’t revolve around diplomacy that the interagency talked about and those discussions are ongoing. Other options that are outside diplomacy,” Kirby said.

“At the very least, you can see how the international community is becoming more galvanized,” he said. “Clearly, what is happening in Aleppo has the world’s attention.”

Kirby declined to elaborate on possible coercive action the United States might consider if the loss of life in Aleppo continues to mount. But he warned that Russia would face ugly blowback from the widening war in Syria if the cease-fire deal fell through.

“The consequences are that the civil war will continue in Syria, that … extremist groups will continue to … expand their operations, that will include attacks on Russian interests, perhaps even Russian cities. And Russia will continue to send troops home in body bags,” Kirby said.

“And they will continue to lose resources, perhaps even more aircraft,” he continued, perhaps alluding to reports citing anonymous US officials that the United States may not be able to halt Gulf nations supplying rebel groups with more sophisticated weaponry to try to defend themselves, including shoulder-fired anti-aircraft missiles. “The stability they claim they seek in Syria will be ever more elusive.”

The US ultimatum to Russia comes as international humanitarian workers issued increasingly desperate pleas about the calamity faced by some 250,000 people in besieged eastern Aleppo in Syrian and Russian air assaults, including the use of bunker-busting munitions that kill people sheltering in underground bomb shelters. Airstrikes targeted two hospitals in Aleppo overnight on Sept. 28, killing doctors, nurses and patients.

“Today [the] 2 main hospitals of #Aleppo were bombarded,” Peter Maurer, the president of the International Committee of the Red Cross, wrote on Twitter Sept. 28. “Patients were killed. Doctors and nurses injured. Wars have rules. Don't attack hospitals!”

“At least 96 children have been killed and 223 have been injured in eastern Aleppo since Friday,” the United Nations children’s fund UNICEF said in a statement Sept. 28.

“The children of Aleppo are trapped in a living nightmare,” said UNICEF Deputy Executive Director Justin Forsyth. “There are no words left to describe the suffering they are experiencing.”

Some 1,000 civilians in eastern Aleppo have been killed or injured in over 1,700 airstrikes the past eight days, Raed al-Saleh, the head of the Syrian Civil Defense group known as the White Helmets, said at the Atlantic Council in Washington Sept. 27.

“We fear that … Aleppo’s destiny will be the complete displacement of all of its people,” Saleh, speaking through a translator, said. “Our demand is to stop the killing itself so that we don’t have to continue this awful job … pulling out corpses from underneath the rubble.”

The White House recognizes that the situation in Aleppo “is much more than a humanitarian catastrophe, it is a political disaster,” former State and Defense Department official Frederic Hof said at the Atlantic Council forum with the White Helmets Sept. 27.

Asked what the United States should do, Hof said President Barack Obama needs to task his secretary of defense with developing options for limited punitive military action, short of a regime change, to raise the cost for the Syrian regime’s assault on civilians in Aleppo.

“I would be content for President Obama to pull in [Secretary of Defense] Ash Carter … and say, ‘Mr. Secretary, what is happening in Aleppo … is simply unacceptable. We are not going to invade this country. We are not going to occupy this country. We are not even going to engage in a campaign of violent regime change. But Mr. Secretary, I want to see some options that will exact a price of people who are currently conducting these civilian-centric terror campaigns with absolute impunity and immunity. Confront them with a price,’” Hof said.

“What is required is for the president of the United States to give an affirmative statement of presidential intent to his secretary of defense, then look at the options, weigh the risks,” Hof continued. “But we need to move quickly here. Because there is hell to pay here.”

But Hof said he would not bet on Obama doing that. “Is there a prospect? Sure. I imagine Kerry and [US Ambassador to the UN Samantha] Power are pushing hard,” Hof told Al-Monitor by email Sept. 27. “And maybe the sheer enormity of what's happening to the people of Aleppo will spur POTUS [president of the United States] into action. But I would not bet on it.”

UN Secretary-General Ban Ki-moon said in New York Sept. 28 that those bombing Aleppo know they are committing war crimes, and he compared conditions in Aleppo to a slaughterhouse.

“Those using ever more destructive weapons know exactly what they are doing. They know they are committing war crimes,” Ban said. “Imagine the destruction. People with their limbs blown off, children in terrible pain with no relief. … Imagine a slaughterhouse. This is worse. Even a slaughterhouse is more humane.”