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Violence against very young children is a public health crisis similar to the "destruction of teenagers by street gunfire," says a federal panel that found five youngsters a day die at the hands of their parents.

"Abuse and neglect has become one of the biggest threats to the lives of infants and small children in America," the U.S. Advisory Board on Child Abuse and Neglect reported Wednesday.Deaths from abuse and neglect of children age 4 and younger outnumber those from falls, choking on food, suffocation, drownings, residential fires or car accidents.

Motor vehicle accidents kill about 1,000 preschoolers, infants and toddlers a year. Twice as many children, the vast majority age 4 and younger, die every year of abuse and neglect.

An additional 18,000 children are permanently disabled, and 142,000 are seriously injured by abusive parents or other caretakers, the panel said.

Most physical abuse fatalities are caused by men who are enraged or under extreme stress - fathers, stepfathers, boyfriends or other caretakers, the report said.

Men primarily assault infants and small children by beating their heads and bodies, shaking them violently, intentionally suffocating them, immersing them in scalding water and other brutal acts. Mothers are held responsible for most deaths caused by severe neglect, the study found.

The report, "A Nation's Shame: Fatal Child Abuse and Neglect in the United States," lists the horrible ways children die.

An unidentified newborn in New York was buried alive. Three-week-old Lindsay Creason of Colorado was smothered to stop her crying. Cimantha Shepeard, 10 days old, was dropped two stories to her death in Illinois. Latoya Harris, 8, was found entombed in concrete in California. In Michigan, Felicia Brown, 11/2, was beaten to death with a shoe heel. Two-year-old Eric Bunphy was beaten and stuffed into a Christmas ornament box in Rhode Island.

"Since we began our study in 1992, some 5,000 children have died at the hands of the very adults they depended upon for safety and love," said Deanne Tilton Durfee, who heads the advisory board.