MILKTEETH by Caitlin Starling – Review

I received this book for free from the Publisher in exchange for an honest review. This does not affect my opinion of the book or the content of my review.

Milkteeth by Caitlin Starling
Published by St. Martin's Press on November 10 2026
Genres: Adult, Horror
Pages: 304
Format: ARC
Source: Publisher
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The nitty-gritty: Sumptuous prose, body horror and complex relationships make up a heady mix in Milkteeth, Caitlin Starling’s outstanding take on the vampire trope.

“You will lose your own needle teeth soon enough. In your maturity, your teeth will be all but identical to your prey’s. Just sharpened, lengthened canines, the better to slice, your saliva doing the rest of the work. It is part of growing up.”

Who says there’s nothing original left to be said about vampires? Caitlin Starling proves there is in this highly original, dark ode to one of our favorite monsters. Milkteeth takes a look at a complex parent/child bond between vampires, but don’t expect a feel good story about the joys of motherhood. This is a visceral, shocking and bloody story that explores the idea of a “broodmother,” a vampire who is selected to raise newly turned vampires for several years until they are able to hunt and fend for themselves. Starling’s writing is gorgeous, and her style is perfect for this tale. Think Interview With the Vampire and you’ll have an idea of what I’m talking about, since the main character Beatrice is telling her story to…someone.

Beatrice lives under an office building in a dark basement with maze-like corridors. She is broodmother to two baby vampires, Fortunata and Gorgeous, who drink her blood whenever they are hungry—and they are always hungry. Young vampires can’t process human blood until they come of age, so it’s up to the broodmother to give them sustenance. Beatrice is given humans to drink by her patron Manon, a cold, controlling vampire who “saved” Beatrice by bringing her to the basement and forcing her to be a broodmother. But Beatrice has a special connection to Fortunata and Gorgeous and loves them in her own way. She also has has ways of sneaking out of the basement and hunting on her own without Manon’s knowledge, so things aren’t all bad.

Beatrice wants to learn more about what she is, how her blood sustains the nurslings and how she can do better, nursing two vampires at the same time. A chance encounter with a doctor gives her hope, but she soon becomes obsessed with the woman, Dr. Bajracharya, which leads to terrible consequences. And when Manon asks her to take on a third nursling, a feral vampire named Lu, Beatrice fears their delicate equilibrium will be ruined.

Starling’s vampire lore is fascinating, and despite the human qualities of her vampires, they are more akin to wild animals. These are starving creatures who can never seem to get enough blood, and they can barely control themselves when they start feeding. Fortunata and Gorgeous don’t hold back when it’s time to feed from Beatrice, and the savagery as they drink her blood is truly shocking. The other thing that surprised me were the ages of the nurslings. At first I pictured them as babies or young children, but Gorgeous is in his twenties, and Fortunata is in her fifties (!), the ages they were when they were turned (which makes sense).

The basement setting adds to the gritty quality of the story. Imagine windowless corridors and rooms, old dank carpeting with years of blood spatter and gore ground into its fibers, and the stench of decaying bodies. Add to this four vampires who rarely get to leave, wearing old, ripped clothing smeared in blood, who are more concerned with feeding than what they look like. Beatrice and her brood, though, call this home, as horrible as it seems. It’s meant to protect them from the outside world, which it does—for a while anyway. The fierce, codependent love they feel for each other, juxtaposed with all the horror and bloodletting, gives the whole story such a poignant feel, and I thought it was so well done.

Beatrice is such an interesting character. It’s hard to really like her, but I felt bad for what she was going through. Manon keeps her on a tight leash, and it’s only through duplicity that she’s able to break away and have somewhat of the life she wants. When she meets Bajracharya, they begin a strange, uncomfortable obsession with each other when Beatrice reveals she’s a vampire. Bajracharya, though, has a secret hidden agenda that is revealed during one shocking scene, and even more shocking is the way their relationship is resolved at the end of the book.

Expect plenty of graphic violence, including some very disturbing body horror, but what elevates Milkteeth above other stories full of violence are the intense emotional moments and complex relationships. Beatrice genuinely cares for her brood, and as their relationships shift from mother/child into something more horrifying, the reader can’t help but sympathize with her situation. Some scenes are simply heartbreaking, although there are glimpses of happiness to balance those out.

On the very last page, we finally learn who Beatrice has been telling her story to, and despite a bunch of clues, I did not figure it out. Milkteeth was such a wonderful surprise, and I will be eagerly awaiting Caitlin Starling’s next book.

Big thanks to the publisher for providing a review copy.