Israel killed 14 people in air strikes in Rafah on Tuesday, Palestinian medical officials said, as the US urged a rethink of a promised ground sweep against Hamas hold-outs in the refugee-clogged city on the southern tip of the Gaza Strip.

More than a million Palestinians displaced by the five-month-old Israeli assault elsewhere in the enclave have been sheltering in Rafah, which abuts Gaza’s border with Egypt.

Israel says one-sixth of Hamas’ combat strength — four battalions of the rifle- and rocket-wielding fighters — is in Rafah and must be crushed before the war can conclude. But the prospect of a civilian toll has raised alarm abroad.

The Israeli military had no immediate comment on the overnight strikes on several buildings in Rafah. Medics said the dead included three women and three children. The identities of the eight men killed were not clear.

With a new round of mediated talks under way on a possible release of hostages Hamas took during an October 7 killing spree in Israel that sparked the war, the White House said it would confer with its ally before any troops or tanks move into Rafah.

“Our position is that ... a major ground operation there would be a mistake,” US National Security Adviser Jake Sullivan said on Monday after a call between President Joe Biden and Israeli Prime Minister Benjamin Netanyahu.

“Most importantly, the key goals Israel wants to achieve in Rafah can be done by other means,” Sullivan added, without elaborating. He said Israeli delegates were due in Washington soon to hear US concerns and “lay out an alternative approach”. At least 31,819 Palestinians have been killed in Israel’s offensive, the enclave’s health ministry said. Israeli officials said their forces have killed around 14,000 Gaza combatants.

In a statement on his conversation with Biden, Netanyahu made no direct mention of Rafah but reiterated the war aims of destroying Hamas, recovering all hostages and pacifying Gaza.

A member of Israel’s security cabinet, agriculture minister Avi Dichter, was sceptical about scrapping a Rafah sweep. “There is no way of destroying the terrorist and military infrastructure of Hamas and Islamic Jihad in Gaza — including in Rafah — through aerial operations or messaging operations or through any other alternatives,” Dichter told Kan radio.

The Washington deliberations, he predicted, would focus on plans for relocating civilians and may include Egyptian input. Sullivan appeared to suggest that the Netanyahu government might place precedence on “a focus on stabilising the areas of Gaza that Israel has cleared so that Hamas does not regenerate and retake territory”.