Motherly instinct kicked in for Grace Bartlett not long after her daughter Anna turned one. She was off her food, was losing weight and was lethargic for about six weeks. A bottle of milk was all she wanted.
A blood test soon confirmed the diagnosis of coeliac disease. It was followed by an endoscopy, that revealed the lining of Anna's small intestine was damaged.
One in 70 Australians are affected by the condition. It occurs in people with specific susceptibility genes (HLA-DQ2 and/or HLA-DQ8).
Why only a small proportion of those genetically susceptible to coeliac disease actually develop the illness is unknown. Environmental factors such as infections may be triggers.
Studies have previously implicated rotavirus, reovirus and a bacteria called Pseudomonas in coeliac disease development. But the observational study that was carried out on infants did not prove a causal effect exists between the virus and the development of coeliac disease.
A lifelong zero gluten diet the only treatment - one that has become part of Anna's daily routine.
"She has adjusted well," Mrs Bartlett said. "She did like toast for breakfast and often had pasta, but being so young, she doesn't remember what she used to eat.
"It's been harder for my husband Peter and I to because we can't have any cross-contamination at home. We do have gluten in the kitchen, but we keep it up on high shelves so Anna can't reach it."
Accidental gluten exposure can lead to symptoms including stomach cramps within minutes, and can slow the process of recovery by days.
Regular small amounts of gluten can also be harmful over time and some studies show that it increases the risk of developing other auto-immune diseases and serious health issues including osteoporosis, fertility problems and cancer.
Coeliac Australia's new national awareness campaign calls on food businesses to treat gluten seriously and highlights how businesses can provide genuine gluten free options.
The campaign, launched during Coeliac Awareness Week (March 13-20), is in response to recent research that found potentially harmful levels of gluten in foods sold and served as 'gluten free'.
Eating out has become a challenge for the Bartlett family, who choose to have most of their meals at home.
"We eat out less," Mrs Bartless said. "If we do go out for a meal, we ask how food is prepared and if safe food handling practices are adopted.
"I want more people who own restaurants and cafes to understand that coeliac is not just a diet choice.
"If more business owners become educated in how to handle and serve gluten free food, people like my daughter can eat out with confidence."
Coeliac Australia chief executive Michelle Laforest says people with coeliac disease want to eat out more often but fear of possible gluten contamination and the debilitating symptoms they may experience is stopping them.
“This inability to enjoy social occasions, something that most Australians take for granted, can negatively impact the wellbeing of people with coeliac disease," she said.
"Gluten free is not a fad. We urge all food businesses to treat gluten seriously and to be aware of their responsibilities when making a gluten free claim.”