Children should never be left alone with family dogs, doctors warned yesterday in the wake of rising hospital admissions caused by dog-bite injuries.

In a report published in this week's influential British Medical Journal (BMJ), paediatricians said parents bringing a dog into the family home should also undertake mandatory classes to teach them the "responsibilities of dog ownership" while children must attend education programmes designed to instil "precautionary behaviour" around dogs.

The proposals are based on data showing the number of people with reported dog bites has doubled in the past decade.

In an accompanying clinical review, Marina Morgan and John Palmer, from the Royal Devon and Exeter Foundation Trust, echoed the view children should not play with dogs unsupervised.

It also states that children should be taught to "treat dogs with respect, avoid direct eye contact and not tease them".

The reports follows the death of a young girl killed by a dog, and calls for a review of the registration of dogs.

In the BMJ study, Rachel Besser, a lifetime dog owner and trainee paediatrician with the London Deanery, said data from the Royal Society for the Prevention of Accidents (Rospa) showed that 70,000 people attended A&E in the UK in 2002 for dog-bite injuries.

Many attacks are on children and take place in the family home, she added.

She said the medical profession was "left to mop up the mess" because people were reluctant to take responsibility.

NHS figures show 4133 people were admitted to hospital for further treatment last year suffering dog bites, almost double the number in 1996. More than a fifth (22%) were children under nine.

Ms Besser argued that the Dangerous Dogs Act does not work because it covers only four breeds and just 764 people were prosecuted under it in 2005.

She argued: "We must stop placing blame on the dogs and focus attention instead on who holds the lead - or who isn't holding the lead as the case may be.

"I would like to see mandatory classes for would-be dog owners to teach them responsibilities of dog ownership."

Inga MacKellar, of the Association of Pet Behaviour Counsellors, said the onus fell upon parents to adopt a common-sense approach. She said: "It depends on the child's age, but I wouldn't leave a toddler alone with a dog. The child might start prodding the animal and not realise it is aggravating behaviour."

The warnings follow the killing of a five-year-old Ellie Lawrenson, mauled to death by a family pet at her grandmother's home in St Helens, Merseyside.