Every day, the staff at the J.E. and Z.B. Butler Child Advocacy Center must face grim realities that most people find hard to hear or stomach: the stories of physically and sexually abused or neglected children, stories often marked by bruises and broken bones.

“If you’re going to be in this field, you have to really love kids,” said director Karel Amaranth. “People say, ‘I could never do what you do, because I love kids too much,’ but to do what we do, you have to.”

The Butler Center, run by the Children’s Hospital at Montefiore Medical Center, expanded this winter and now includes three Bronx sites — its main building at 3314 Steuben Ave., a counseling center at 3380 Reservoir Oval East, and its newest location, further south, on East 188th Street and Valentine Ave., acquired in January from St. Barnabas Hospital.

The Butler Center is the only certified, medically-based clinic of its kind in New York, Amaranth said, and its goal is to offer comprehensive and holistic treatment for abuse victims and their families, from medical exams to counseling.

“Our mission is to intervene in child abuse in any point that we can,” she explained.

The Steuben Avenue location is a cheery, two-story building, where a staff of pediatricians, nurses and social workers perform medical exams and conduct interviews.

Rooms are equipped with one-way mirrors so prosecutors and other law enforcement officials can watch as a social worker talks to a child, and exam and interview rooms are made less clinical by soothing colors on the walls, as well as dollhouses and tables littered with coloring books and games.

A majority of their patients are victims of sexual abuse, Amaranth said, and around 80 percent of the children they see are referred to the clinic by the Administration for Children’s Services. According to the city agency’s data, there were 20,165 cases of child abuse or neglect reported in the Bronx in 2009, the most recent year listed.

The month of April is Child Abuse Prevention Month, which advocates mark with light blue ribbons and campaigns to increase awareness.

“It’s so important for poor women who are single parents to have resources and someone to talk to,” said Lynn Hamberg, the assistant director at the Butler Center who oversees the new site on East 188th Street. “Isolation is the most dangerous environment.”

Both Hamberg and Amaranth say the best tool for prevention is dialogue, something that’s become easier to accomplish in recent years as the topic of child abuse has lost some of its taboo-factor.

“I think for a long time it was spare the rod, spoil the child — this was something that took place in the family, and you didn’t talk about it,” Amaranth said.

The most deadly course of action, both say, is silence.

“So many cases of child abuse are perpetrated just because no one says anything,” Hamberg said. “Children aren’t starved to death and beaten without anyone knowing about it. People need to speak up.”

Editor’s Note: For more information about the J.E. and Z.B. Butler Child Advocacy Center and its programs, visit the center’s website at www.montekids.org/programs/butler or call (718) 920-5833.