Posted in: Events, NYPS Group News, Patient Stories , Monday June 4, 2018

Two-year-old Gerard Avellaneda of Huntington was selected as the honoree for this past weekend’s Smile Train Family Day on June 2. His family and his surgeon, Dr. Rachel A. Ruotolo, were there to celebrate with him. Gerard was born with a bilateral cleft lip and palate and has undergone 3 surgeries to date, with more to follow as he grows.

Cleft lip and palate is widely perceived as a problem of developing countries, yet here in the United States, more than 4,400 babies are born each year with this condition – roughly one in every 940 births.  It is one of the most common birth defects in this country (second only to congenital heart defects). In children with a cleft lip and/or cleft palate, the upper lip and roof of the mouth, and sometimes the nose, do not form correctly in utero, leaving a gap or gaps in the lip and a hole in the roof of the mouth. Children with cleft can have problems with feeding, eating, and speaking. They are also prone to ear infections, hearing problems and issues with their teeth. But the condition is treatable with the right medical and surgical care.

Gerard and Dr. Ruotolo

At 20 weeks into their pregnancy, Gerard’s parents learned about his developmental anomaly after a routine ultrasound exam.

“At that point in the pregnancy, most parents are learning the gender of their baby; we learned that our baby had a significant anatomic abnormality,” said Gerard’s mother, Meaghan Avellaneda. “We learned that Gerard would require extensive surgery beginning soon after his birth, so we began interviewing surgeons.”

Their search led them to Dr. Ruotolo, with whom they felt an immediate connection. “Dr. Ruotolo was experienced, knowledgeable, compassionate, and extremely thorough,” said Mrs. Avellaneda. “We knew we wanted to take this journey with her and looking back, we feel we couldn’t have gotten through it without her.”

After his birth, Gerard was fitted with a Nasoalveolar Molding (NAM) device that would begin to guide his anatomy into better alignment to prepare him for his first surgery. The family visited Dr. Ruotolo weekly for almost 4 months. Then began the surgeries; three of them to date. Gerard will need bone graft surgery when he is 7 years old to complete the repair, adding structure to his jaw, fixing his gums and giving his permanent teeth a place to erupt.

Thank you to Gerard, his family, and all of the participants of Saturday’s Smile Train Family Day Walk. Together we can help spread awareness of the prevalence of cleft lip and palate in the U.S. and the importance of seeking prompt expert surgical treatment.

Dr. Ruotolo (center) and the LIPSG Team on site at the Smile Train Walk

About Smile Train
Smile Train provides free cleft surgery and comprehensive cleft care to children in developing countries. Through training local doctors and empowering partner hospitals around the world, we advance a sustainable solution and scalable model to treat clefts, drastically improving children’s lives, including their ability to eat, breathe, and speak over time. To learn more about how Smile Train’s sustainable approach means donations have both an immediate and long-term impact, please visit