A review into the deaths of two Sussex toddlers murdered by their former city worker mother has said professionals must remember “child abuse crosses all class boundaries”.

The review into the deaths of Harry and Elise Donnison, three and two, said doctors, police officers, teachers, nursery and social workers may have been swayed by the “gender and class” of their killer mother Fiona Donnison, who was jailed for a minimum of 32 years after smothering them in January 2010.

The review recommended details of the case, which saw Donnison drive the children’s bodies from their temporary home in Lightwater, Surrey, where they were killed, to the family home in Cross-in-Hand, Heathfield, should be passed around all line managers of relevant agencies in Sussex and Surrey, including the police and NHS, to prevent a similar tragedy.

The review hoped it would “encourage reflection” among people and test “allegations and assumptions, particularly where factors such as class and gender may be influencing responses”.

In total the report made 42 recommendations for change, including suggesting East Sussex Hospitals Trust reviews all sudden and unexpected deaths of children under the age of two – a review the trust yesterday confirmed is currently taking place.

It also suggested children in East Sussex should be assessed if there has been another youngster who has died in the family.

Donnison’s first daughter, Mia, died suddenly at the age of nine months in 2004.

The review said Sussex Police needed to address an “organisation culture” where children were perceived as being the responsibility of specialist officers in the force.

It said children were the “statutory responsibilities of everyone in the organisation”.

Schools in East Sussex were recommended to be more aware of split-parent families – Lewes Crown Court was told Donnison killed the children as “pawns” to get back at her ex, and the children’s father, Paul.

The review concluded any future research into lessons from serious case reviews should explore the relationship between parental separation and risks to children.

The report also referred to assumptions made by staff at Huffle Nursery in Beechwood Lane, Heathfield, which the children attended, about the couple’s relationship. It said “all supervisors working with children [must be] fully informed about children’s circumstances”.

An East Sussex County Council spokeswoman said: “Our contact with the family in this case was very limited and very low level and we are confident we acted correctly.

“The serious case review has concluded that at no point could anyone have predicted the mother would seriously harm or kill her children.”

Detective Chief Inspector Carwyn Hughes, of Sussex Police, said: “We have taken action on the two recommendations addressed to Sussex Police, out of the 42 recommendations in total.

“The recommendations did not relate so much to specific actions taken in this case, but rather to a wider issue about our ability to handle information and make it available within the force and to partners.

“Over the past three years our IT systems and supporting processes have developed to a stage at which we are able to operate much more effectively.”

Jeni Woodhouse, from the Huffle Nursery, said: “I have frequently looked into my heart and considered if I should have done anything differently. There is nothing that we could have done that would have changed the devastating outcome.

“My staff and I were deeply affected by the tragedy and we have planted two weeping cherry blossom trees in the garden in their memory. One white and one pink.”

A spokeswoman for the East Sussex Local Safeguarding Children Board said: “The purpose of any serious case review is to identify ways in which agencies involved in an incident could improve how they jointly safeguard children.

“From a very sad tragedy like this, it’s vitally important any lessons to be learned are highlighted and acted upon.”