The Rat Child is a creature found in the nursery of the Rat-Infested Apartment on the first floor. Regardless of the player's choice, Sam will initially be unable to bring himself to either kill or take the infant with him, deciding to leave it in the crib. However, it will crawl after the player and enter their inventory when they try to leave. When the player is trapped in the room with the wall mouth later, they may feed the child to the mouth to be released, or sacrifice an arm instead to spare it. It will remain in Sam's apartment and eventually grow into a companion who can join the party.