The Reliance GP Blog

Healthy by Reliance

Vitamin D in Pregnancy, Infancy and Childhood

Missy Tysoe May 9, 2017

Vitamin D in Pregnancy, Infancy and Childhood

If you avoid the sun, suffer from dairy intolerance, or follow a strict vegan diet, you may be at risk for vitamin D deficiency.

Vitamin D plays a vital role in building strong, healthy bones, absorption of calcium in the intestine, muscle strength, and the function body’s nervous and immune systems.
Research has shown that low vitamin D in pregnancy, infants, children and adolescents is associated with a wide range of health problems that can extend into adulthood.

Who is most at risk of vitamin D deficiency?
Vitamin D deficiency is possible if you or child:

Deliberately avoids sunlight

Wears clothing that covers most of the skin

Spends long periods indoors because of disability or illness

Lives in Victoria or Tasmania

Has naturally dark skin

Has a medical condition or takes medication that affects vitamin D levels, such as obesity, liver or kidney disease, cystic fibrosis, celiac disease or inflammatory bowel disease

An infant, child or adolescent with at least one of these risk factors may need a test to check vitamin D levels – your doctor will know whether the risk is high enough to necessitate a test. If you are pregnant with at least one risk factor, you should ask about a vitamin D test at your first antenatal visit.
If you had at least one risk factor during your pregnancy AND your baby is fed only with breast-milk, your baby may need vitamin D drops. Around 400IU of vitamin D (10mcg) a day is usually sufficient. In some cases, your doctor may also recommend that your baby has a blood test for vitamin D.


Vitamin D, sunlight, food, bone health



During pregnancy, the mother’s body adapts naturally to cope with the requirements of the growing baby. If you have normal levels of vitamin D during your pregnancy, you will be able to provide the right amount both for your own health, and for your baby’s needs. If your vitamin D levels are low during pregnancy, your baby is also likely to be vitamin D deficient.
Infants, children and adolescents
Infancy, childhood and adolescence are periods of rapid bone development and growth, so adequate vitamin D is essential at these times. Severe vitamin D deficiency in infants and young children can lead to rickets, a disease that causes weak and deformed bones (‘bow-legs’) that are prone to fracture. Children with vitamin D deficiency can also suffer pain in the bones and muscles, and muscle tiredness and weakness. Deficient children may not grow and develop at the normal rate, and may be late teething. They are also more likely to get chest infections and suffer from other health problems.


What are the best sources of Vitamin D?

  • Sunlight is the most important source of vitamin D for Australians of all ages, including breast-fed babies and infants. The amount of sun exposure needed will depend on skin colour, the time of year, time of day, whether the skin is covered (with clothing or sunscreen) and location. For more information on sun protection for babies and children, read the blog here.
  • Food is a poor source of vitamin D for most Australians. Some types of oily fish, including salmon and mackerel, naturally contain vitamin D, as do eggs, meat and liver. Fortified Dairy including most milk, and some grain products have vitamin D added to them.

How to keep your vitamin D levels up during Pregnancy
Being outside for 5-10 minutes on most days in summer with your arms exposed at mid-morning or mid-afternoon will maintain your vitamin D at normal adult levels during pregnancy. In winter, up to 40 minutes exposure at mid-day may be required, depending on your skin type and where in Australia you live.

Keeping Vitamin D levels up in Infants, children and adolescents
Although breast-milk is highly beneficial, it contains very little vitamin D. Breast-fed infants rely almost entirely on safe sun exposure for their vitamin D requirements. Infants who are fed only with formula should get all of the vitamin D that they need from formula milk. Older infants who are on a mainly solid food diet, as well as children and adolescents, are dependent on sunlight for most of their vitamin D needs.
It isn’t possible to make a single recommendation for safe sun exposure that is suitable for all Australian infants, children and adolescents, so some general advice has been developed1. Outdoor play and physical activity throughout the year is recommended for these age groups and this carries many other benefits! In summer, a hat and sunscreen should be worn, and most outdoor time should be spent in the shade.
Can vitamin D deficiency be treated?
Regular outdoor play or exercise for infants, children and adolescents and pregnant women (with sun protection if the UV index is high) is the best way to correct mild vitamin D deficiency. Your doctor may also recommend a daily vitamin D supplement. Severe deficiency may need treatment with a high dose of vitamin D to begin with, followed by a regular lower dose to maintain normal levels. Please consult a Doctor before doing so. To book an apoointment call 43041 333
It is important that you discuss with your doctor anything about your own or your child’s lifestyle or health that may have caused vitamin D deficiency, and ways in which these might be changed to prevent deficiency occurring again.


Resources: Medical Journal Australia

Vitamin D in Pregnancy – consumer information leaflet


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Tags: bones children dairy deficiency food health immune system infant intolerance muscle pregnancy pregnant sunlight vegan vitamin d

Reliance Living Initiatives for our people

Missy Tysoe August 15, 2016

Reliance Living Initiatives for our people

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Health & Wellness

At Reliance we care about our people’s well-being and have a variety of health and wellness initiatives to ensure that we provide a happy and healthy environment for our team. The wellbeing of our employees can influence their contribution to patients and the community. We aim to create an environment in which our people are happy, healthy and thriving. We want our people to enjoy their working environment, and to bring the best of themselves to their roles every day.

Benefits of worksite wellness programs for employees include:

  • Improved physical fitness
  • Effective weight management
  • Increased stamina
  • Lower levels of stress
  • Increased well-being, self-image and self-esteem


Health & Wellness incentives offered at Reliance:

  • Fresh fruit delivery every week
  • Clinical Pilates classes on Friday at lunchtime-class runs for 45 minutes but you can feel free to do a shorter class during your break
  • Anytime Fitness gym program-reimbursement on attendance
  • Intouch Hair voucher-50% of cut and finish
  • Free flu shots for you and your family
  • Free and Discounted Physiotherapy & Excercise Physiology offers (see below)

Click here to view Reliance Living initiatives flyers

Get fit and healthy anytime with Reliance

We have around 25 staff and practitioners participating in our Anytime Fitness gym reimbursement program. If you are not already signed up and would like to join, please contact the marketing team.

Did you know exercise can boost productivity and engagement in the workplace?

Increased alertness and energy

One way that exercise can help boost productivity at work is through alertness. When you exercise, you are also increasing blood flow to the brain, which can help sharpen your awareness and make you more ready to tackle your next big project. Exercise can also give you more energy.

Promote optimum physical health

Being in your best physical health will help improve your overall work ability. Not only can exercising help reduce body weight and the risk for certain medical conditions, you also will have improved cardiovascular health, which will give you more stamina to meet the physical demands of your job. This will also reduce your risk of becoming injured on the job and allow you to meet the expectations required for your position.


We are always looking for additional incentives for our people and are open to feedback and input regarding inclusions. Please email with any ideas.

Personal development

Personal development of our people is important at Reliance. Our pathway to vocational training program offers specialised seminars for practitioners and is also open to all employees and the local community. These valuable topical seminars help educate our community about various health related conditions and preventative measures.

Reliance has recently introduced the Reliance Mentoring Program. Mentoring is a proven approach to drive valuable learning and development for both mentees and mentors while significantly benefiting the organisation.

Reward & Recognition

At Reliance we value our people’s wellbeing and as such wish to reward and recognise them appropriately.

Reliance wish to foster an enjoyable environment in which employees can continually improve whilst increasing positive engagement of employees and encouraging best practice sharing and internal promotion. High performers who consistently demonstrate the Reliance corporate values are recognised and rewarded on a monthly and annual basis.


As part of the Reliance staff wellness initiative, Platinum Physiotherapy is excited to offer the following for all Reliance Health team members (includes reception, administration, management, doctors, nurses, specialists and allied health practitioners):

  • FREE EXERCISE PHYSIOLOGY – Book in with Daniel for free consultations until the end of September to help get your health back on track.
  • FREE CASUAL CLINICAL PILATES –  Book into any Pilates class for free when booked no more than 3 business days prior.
  • BULKBILLED PHYSIOTHERAPY – No gap fee when booking in for physiotherapy with Kim or Helen using an eligible EPC.
  • DISCOUNTED ONGOING PILATES – Pre-book an ongoing class day/time for a minimum of 4 weeks for a discounted rate of $20 per class (RRP $35).
  • DISCOUNTED PRIVATE PHYSIOTHERAPY – 20% discount for all physiotherapy consultations where not eligible for an EPC.

Simply book in at reception or by call ext 1316.


Download the pdfs below to view our full list of culture initiatives for our people:

Health & Wellness Incentives

Staff Development & Training

Rewards & Recognition (3)


Internal Communications (1)


Winter is a good time for a skin check: Skin Cancer Clinic Now Open

Missy Tysoe June 28, 2016

Winter is a good time for a skin check

Reliance Skin Cancer Clinic now Open


Did you know?

  • Australia has among the highest rate of skin cancer in the world.
  • About 2 in 3 Australians will be diagnosed with some form of skin cancer before the age of 70.

One of the most important things you can do for your health this winter is to get your skin checked. While many people take on-board the sun-smart, slip slop slap message during summer, it is often neglected during the winter.

Skin cancers can develop at any time so sun protection measures and skin checks should not be neglected during the colder months. Skin lesions from sun damage during summer months won’t show up overnight. It may take months or years for the damage to develop into a skin cancer. During summer we are far more likely to notice moles or unusual spots as more of our skin is exposed. In winter, we are heavily clothed and as a result often less likely to notice suspicious moles

Additionally, winter may prove to be the most ideal time for a full skin check. As most people are covered up during the winter months, this minimises sun exposure to skin lesions and moles. This can allow for better dermoscopy viewing (a distinct magnifying light, which allows a doctor to closely examine spots on the skin).

What to look out for?

Any change or sudden appearance of freckles, moles, sores or spots, even just reddened areas may be an indication of skin cancer and you should see a doctor. Reliance Medical Practice now offers a comprehensive Skin Cancer Clinic at our West Gosford and Wyong sites and we welcome new patients. The doctors involved in the Reliance Skin Cancer Clinic are highly qualified and experienced in this area.

By checking regularly you will get to know when something has changed. Change is one of the important things to look for, a change could involve a change in colour, change in shape (e.g. it used to be perfectly round and now it looks like a map of Australia), change in surface pattern (e.g. it used to be smooth and it is now rough), or if it becomes a sore that won’t go away.

Talking to your doctor:

To get the most out of your visit to your doctor:

  • visit a skin cancer clinic with doctors who specialise in this area ie Reliance Skin Cancer Clinic
  • request a longer appointment if you have a number of issues to discuss
  • prepare your questions beforehand
  • take a friend or relative for support, or to write down answers to your questions if possible
  • ask your doctor to explain again, if you don’t understand the answers
  • ask your doctor to give you a written summary of your treatment plan


Be skin smart this winter

Remember to protect your skin this winter by applying 30+ sunscreen to exposed areas of skin such as the face and hands and don’t forget your lips and ears, and wear protective sunglasses or googles for work, sports and anytime outside. If you notice a spot on the skin that looks different from the others or is changing, bleeding or itchy, it should be examined by a doctor.

Protect you and your loved ones skin and book an appointment with your GP today. Call 02 4304 1333 or visit

Reliance Medical Practice

Reliance Skin Cancer Clinic- West Gosford and Wyong

Download the pdf here.

Melissa Tysoe | Marketing & Events Assistant | Reliance GP Super Clinic

Tired of not getting your beauty sleep? Common reasons for having trouble sleeping and what to do about it.

Rod Beckwith April 14, 2016

Tired of not getting your beauty sleep?

Common reasons for having trouble sleeping and what to do about it.

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There is nothing more frustrating than waking up in the middle of the night and not being able to get back to sleep, or not being able to sleep when you first get into bed. Sleep is critical for the body for it is when we heal and grow. recover from  Unfortunately, sometimes it can be hard to work out the cause, but it’s really important to try to figure out why you are having trouble getting some solid shut eye. If you know the reason that you’re having trouble sleeping, it can be easier to resolve the problem.
Common reasons for having trouble sleeping 

  • Not being able to stop thinking or switch off your mind.
  • Not getting enough exercise or sunlight.
  • Eating food too close to bedtime or Exercising too close to bed time which stimulates you for a number of hours afterwards.
  • Taking stimulants, like caffeine or nicotine, too close to bedtime.
  • Some medications. Some diet pills, blood pressure, allergy and asthma medications can cause sleeping problems. Talk to your GP about your medication possibly affecting sleep.
  • Disrupted daily cycle. Your body works on a 24 hour cycle and releases hormones at certain times of day to prepare you for certain events, such as falling asleep and waking up. These rhythms are called circadian rhythms and when they get out of whack it can cause all sorts of problems including sleep issues.
  • Being awoken by chronic pain.
  • Feeling anxious about something. Often, if you’re having trouble getting to sleep when you first go to bed, it’s because you feel tense and worried. If you are concerned about this please visit your GP.
  • Feeling down or depressed. Sometimes, when people wake up in the night it’s a sign that they’re feeling pretty down. If you are experiencing this please visit your GP.
  • Environmental issues– e.g. being too hot or cold, or there being too much noise.
  • Other physical problems.Sometimes, if something is wrong with you physically, one of the signs is having trouble sleeping, please see your GP.

When does having trouble sleeping cause a problem?

Everyone has trouble sleeping from time to time – as annoying as it is, it’s completely normal to have bad night’s sleep occasionally. It can even be common to go through a bit of a bad sleeping phase, particularly if something upsetting is going on. There is a point though, where having trouble sleeping becomes more concerning. Signs you should look out for are:

  • Being tired all the time and having no energy from not sleeping
  • Falling asleep during or at work
  • Not being able to complete any work you need done because you’re too tired
  • Not being able to concentrate
  • Becoming really forgetful and struggling to remember things
  • Feeling emotionally on edge or becoming unusually moody
  • If sleeping troubles have been going on for longer than a month

What to do about it? 

There are many strategies you can use to help you get back into a good sleeping pattern, which you can find in the fact sheet about getting into a sleeping routine

If these strategies don’t work, if you’re feeling anxious or depressed, or if you just can’t figure out the reason behind your sleeping problem, it’s a good idea to visit your GP to bring up your sleeping issues. It will be much easier and faster to work out what’s going on, and treat the problem, if you seek professional help.

Reliance Sleep Study Clinic 
We welcome the addition of Reliance Sleep Study Clinic. Dr Levi treats sleep apnoea, snoring and other sleep disorders. Sleep problems can cause fatigue, tiredness, breathing problems and other health complications. When we sleep – different bodily functions slow down and this change in levels can cause problems for some people.

The clinic conducts a non-invasive take-home test that collects sleep data during one night of sleep, and is bulk billing. To find out more click here. Make an appointment with your GP if you have any sleep concerns Call 0243 041 333 or book online


Reach out-





Reliance Top Tips to a Healthy and Happy Easter!

Missy Tysoe March 24, 2016

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In general practice the most common time to see patients suffering acute illness (cold & flu, gastro) is around Christmas and Easter. This happens for a variety of reasons; less sleep, more stress with a busy schedule, and of course excess consumption of nutritional nasties like sugar.

Too much sugar can slow down your immune defence and leave you susceptible to illness. The high GI in chocolate can lead to a spike in insulin levels, which can leave you feeling lethargic and groggy.

Here are some tips for keeping your health on track this Easter;

  • Plan your meals ahead to avoid binging, and try to fill up on wholefoods like fresh meat and veges before you get to dessert.
  • If you really want to eat that chocolate egg, eat in moderation and try waiting 15-20 minutes after a meal for your brain to catch up to your stomach.
  • Keep active – play some games with the family. Exercise will help to balance the spike in your blood sugar from the sweets. Plus in the long-term, exercise reduces the risk of almost all chronic disease including heart disease, cancer and type-2 diabetes.  Did you know it takes about 20 minutes of exercise to work off an small 17g hollow easter egg? An innocent looking hot-cross bun will take about an hour of intense physical activity to burn off!
  • Substitute, substitute, substitute. This way you won’t feel like you are missing out.

Here are some substitute ideas to give your body the nutrients it needs, without compromising on taste.

Chocolate Eggs: Dark chocolate, carob chocolate, or hollow eggs instead of filled. Try these wholefood recipes created by our very own nutritionist Nicole Saliba, “Sweet Stuff” dessert recipes can be found here including; Choc-Chia Cookies, Paleo Cohcolate Cookies, GF Tahini balls, Low GI Muesli Cookies, and Choc-bit Bliss Balls.

Choc dipped strawberries: Fruit kebabs (chopped fruit on a skewer – great for entertaining)

Cream: Natural Yoghurt

Cheese & Nibbles: Waldorf Salad, Apple pomegranate salad, kale and walnut pesto recipe available here.

Caramelised Pork Belly: Roast Pork and seasoned Veges. Other main recipes are available on the eat-sense website

Apple Pie: Our nutritionist-certified Apple Berry Crumble recipe


Reliance wishes you and your family a happy and healthy Easter!

We would like to remind you that Reliance GP Super Clinic will be open every day over the easter weekend, from 7AM – 10PM. To make an appointment call 0243 041 333 or book online at

In addition, our Radiology will be open for x-rays this weekend on Saturday and Sunday from 12PM – 3PM.


Melissa Tysoe | Marketing & Events | Reliance GP Super Clinic

  • Easy online booking available anytime

    For your convenience and ease we have an online booking system to enable fast access to our services 24/7. Try it today.

    Make an appointment

  • This development is supported by financial assistance from the Australian Government under the GP Super Clinics Program.

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