Death Stranding features a breastfeeding ghost baby, and Geoff Keighley

The latest trailer for Death Stranding held a few surprises for us today.

The upcoming action game from Kojima Studios features a breastfeeding ghostly baby as a central subplot. The video begins with a horrified Norman Reedus, who spots the ghost baby on the ceiling - a scene reminiscent of Trainspotting, only the warbling babe is an invisible, floating baby-shaped mass.

The baby, who is supposedly born in the afterlife, is still attached to its mother by its umbillical cord somehow. Its mother, known as Margaret Qualley - AKA Mama - coaxes the baby from the ceiling then begins to breastfeed it over her shirt. "Even though she can't drink it, my body keeps making it," she says of her lactation situation, before motioning to her breasts. "Going through the motions really helps with the soreness."

Gamescom's Opening Night Live presenter and friend-to-Hideo Kojima Geoff Keighley also gets a role in the game, not as a baby but rather as a holographic dude. Keighley was scanned a few years ago but was never told what it would be used for, he said during today's presentation. The game will feature many more recognisable faces, with those reveals coming at a later date.

In a short gameplay trailer shown during today's event, viewers also got a chance to see how Reedus plays as a character. Most notably, you'll be able to pee freely in the game, all while having a baby strapped to your chest.

Death Stranding will launch on PS4 – and possibly other platforms – on November 8, 2019.