The Binding of Isaac: Afterbirth/Changes

Items

Activated Collectibles

Bob's Rotten Head

• The head deals 3 times Isaac's tear damage as poison over time instead of either 6 or 8 points.

The Book of Belial

• Increases the chance to open the Devil Room or Angel Room by 12.5% after killing a boss while holding it instead of guaranting it.

Book of Revelations

• Increases chance for a Devil/Angel Room Door to open by 17.5% instead of 35%.

Butter Bean

• Knocks back enemy shots.

Crack the Sky

• The beams have a high chance to directly target enemies.

D4

• Previously held items are removed from the pause menu.

The D6

• Reroll an item after defeating The Fallen no longer replace the Devil Room item he drops to a random item from the normal boss item pool.

D10

• Fly enemies are only rerolled into other fly enemies.
• Red flies can't be rerolled anymore (even though enemies can be rerolled into them).

Flush!

• Floods the whole room with water.
• Flushes all poop-related enemies and bosses away.
• The ladders are covered in water but the walls are not when used inside a crawl space.

Guppy's Paw

• Can no longer be used without red heart containers.

Head of Krampus

• Has a 50% chance to rotate all beams around the player 90 degrees, similar to Krampus' second Brimstone attack.

The Jar

• Sprite changed.

Monstro's Tooth

• Has no effect if Monstro is in the room the item is used in.

The Poop

• Knocks back enemy shots.

Scissors

• Its recharge time is 2 rooms instead of 6 rooms.

Undefined

• Dark Room can no longer be cleared repeatedly.

Passive Collectibles

20/20

• Sprite changed.

3 Dollar Bill

• The type of randomized tear changes every 2-3 seconds. The item appears to select two tear effects at once, perhaps staggering the times at which each of those effects change.
• If a run is quit, and then continued, 3 Dollar Bill will keep tear effects for the current room.

Abel

• Abel shoots tears towards Isaac regardless of which direction Isaac is shooting.

Ball of Bandages

• Ball of Bandages blocks enemy shots.

Bob's Brain

• Bob's Brain is fired directly from where it is located in the chain of familiars behind Isaac, making aiming it slightly more difficult.

Bomb Bag

• Can drop a Gold Bomb.

Box

• Can drop a Gold Bomb.

The Common Cold

• The poison hits twice, dealing a total of double Isaac's damage.

Dr. Fetus

• Each bomb deals 5 times the character's normal tear damage instead of 3, plus a flat 30 damage. The flat 30 is not affected by damage multipliers.

Lord of the Pit

• Speed boost is applied immediately.

Mom's Contacts

• Range and tears height buffs are applied immediately.

Steam Sale

• Having multiple Steam Sales reduces all shop prices to 0 coins.
• Causes the Deals with the Devil not to convert the heart type automatically.

The Virus

• Each poison hit deals damage equal to Isaac's tear damage instead of 4 or 6 damage.
• Enemies killed after they have been inflicted with this type of poison have a 20% chance to drop black hearts.

Trinkets

• Can replace the Tick.

• No longer displays a particular puzzle piece on the last will screen if Isaac dies in a Sacrifice Room while holding it.
• Dying in a Sacrifice Room while holding it unlock The Lost, regardless of current character.
  • If The Lost was already unlocked, Isaac will be revived as The Lost and Missing Poster will be consumed.
  • If the player's character is already The Lost, he will be revived in the previous room and Missing Poster will be consumed.

• Small chance to revive Isaac as The Lost upon death, like Missing Poster.

• Can be replaced by Match Stick.

Interactions

20/20 + Brimstone - Two brimstone shots are fired, without an increase in charge time. 20/20 + Epic Fetus - Makes two missiles drop one after the other. 20/20 + The Inner Eye - 5 shots are fired with the normal decrease in fire rate instead of 3. 20/20 + Mom's Knife - Two knives are now thrown instead of one. 20/20 + Mutant Spider - 6 shots are fired with the normal decrease in fire rate. 20/20 + Technology - Two technology shots are fired simultaneously. Azazel + Technology - Technology laser wraps around the Brimstone beam, dealing extra damage, but not increasing Brimstone range. A Lump of Coal + Brimstone - Beam will gradually increase in size and damage the farther it travels, on a multiplier that is roughly +20% per tile of distance. A Lump of Coal + Technology - Damage increases the further away the enemy is, on a multiplier that is roughly +20% per tile of distance. A Lump of Coal + Technology + Tiny Planet - The extra distance covered by the laser more than doubles damage right in front of Isaac, and it increases as normal further away. A Lump of Coal + Technology 2 - Damage increases the further away the enemy is, on a multiplier that is roughly +20% per tile of distance. BBF + Brimstone - BBF will fire brimstone beams in all directions upon exploding. Brimstone + Dr. Fetus - Isaac continuously fires bombs while charging the blood laser. Overrides Azazel's blood laser. Brimstone + Epic Fetus - Fires lasers in all directions upon impact of a missile. Brimstone + Monstro's Lung - Several additional lasers fire in random directions. One beam always fire straight forward as normal. Brimstone + My Reflection - Makes the beam curve when moving. Brimstone + Proptosis - Doubles damage but it rapidly decreases with distance, down to 0.1 from about 6 tiles away. Brimstone + Technology - The Technology laser coils around the Brimstone beam, granting a 1.5x damage multiplier. Cricket's Body + Dr. Fetus - Bombs split outwards into 4 tiny bombs that are not affected by Isaac's bomb modifiers, which detonate almost immediately. Dr. Fetus + Hot Bombs - Bombs leave behind fire that damages enemies on contact after exploding. Dr. Fetus + Mom's Knife - Isaac continuously fires bombs while charging the knife. Dr. Fetus + Monstro's Lung - Shoots 6 bombs which need to be fully charged before firing. The bombs detonate simultaneously. Dr. Fetus + Mysterious Liquid - Exploding bombs leave behind a large pool of green creep. Dr. Fetus + The Parasite - Bombs split into two bombs upon exploding. Dr. Fetus + Poison tears - No damage increase from poison. Dr. Fetus + Polyphemus - Bombs become Mr. Mega bombs. After they explode, they leave behind a regular-sized bomb. Dr. Fetus + Sad Bombs - Fires tears as normally placed Sad Bombs would. If this synergy is combined with Ipecac, the tears from the bomb become explosive, which Isaac is not immune to. Tears fired from previous Dr. Fetus bombs can collide with other Dr. Fetus bombs (can be negated with spectral tears). Dr. Fetus + Spoon Bender - Bombs are purple and act as if Isaac had Bobby-Bomb. Dr. Fetus + Technology - Both bombs and lasers are fired. Dr. Fetus + Tough Love - Tears that would have fired a tooth shot instead become a bomb with the Mr. Mega, dealing more damage and shaking the screen. Epic Fetus + Spoon Bender - Cursor slides towards enemies. Epic Fetus + Telepathy For Dummies - Cursor slides towards enemies. The Inner Eye + Mutant Spider - Shoots 7 tears instead of 3. No further decrease in fire rate. Mom's Knife + Technology - Both fire normally. My Reflection + Technology - Makes the beam curve when moving. Has the same effect on Azazel's mini-brimstone and doubles the range. Mysterious Liquid + Technology - The laser spawns pools of liquid always when it hits obstacles and occasionally on enemies. Rubber Cement + Technology - Lasers bounce off of walls.

Pickups

Bombs

Troll bomb

• Troll Bombs are now given a random amount of time before exploding. Before that they always exploded at a fixed time. This means that if two Troll Bombs spawn at the exact same time right next to each other, there's a high chance one Troll Bomb will blow up before the other, sending that Troll Bomb sliding outwards a bit before exploding.

Entities

Monsters

Bony

• Only leaves behind bones when killed.

Environment

Rooms

Boss Room

• Double Trouble boss rooms can now contain 2 bosses of different types. Additionally, they can appear as early as Chapter 1.

Arcade

• An Arcade can contain a bed, a key master and 3 hanging dead shopkeepers.

Angel Room

• Possible rewards found in the room include:
  • 2 angel chests
  • 1 eternal heart, and 4 soul hearts behind key blocks
  • 6 coins
  • 2 soul hearts and 1 gold heart.
• Urns might spawn in the room.
• Killing Key key master and shell game beggar no longer applies the 25% bonus.
• Donating to a normal beggar until it pays out with an item on the current floor applies a 10% bonus instead of 25%.
• Donating to a Devil beggar until it pays out with an item on the current floor applies a 10% bonus instead of 25%.
  • If this coin flip succeeds, a Devil Room will be generated regardless of the above coin flips.
• "You feel blessed!" fortune in the Sacrifice Room of the current floor applies a bonus:
  • If the "You feel blessed!" fortune appeared on the 3rd sacrifice, the chance will be 15%.
  • If the "You feel blessed!" fortune appeared on the 5th sacrifice, the chance will be 50%.
  • If both "You feel blessed!" fortunes appeared, the chance will be 65%.
• Angel Rooms that spawn after Isaac defeats Mom's Heart or It Lives will be normal Angel Rooms with items or pickups.
• A troll bomb can sometimes appear behind the Angel Statue, blowing it up. If the Angel fights have been unlocked, this will begin the boss fight if the player is not careful or quick enough to move the bomb.

Bedroom

• The clean bedroom occasionally has two clean beds instead of one.
• The trapdoor in a dirty bedroom has a chance to lead to a Crawl Space.
• Occasionally, one Rag Man will spawn inside the dirty bedroom.

Boss Rush

• There is a chance that there will only be 2 items to choose from. Additionally, items may be trapped behind rocks or spikes. Items may appear in the corners of the room instead of the center.
• All 15 waves are randomized. Each wave spawns two random bosses from the list. Each boss can only appear once per Boss Rush.
  • Brownie, Dangle, Dark One, Dingle, 3x Gurglings, Little Horn, Mega Fatty, Mega Maw, Polycephalus, Rag Man, The Adversary, The Cage, The Forsaken, The Frail, The Gate, The Haunt, The Stain, and 3x Turdlings can appear in the Boss Rush.
  • The angels Uriel and Gabriel can also appear.
• New layouts:

• If a sack spawns for whatever reason, picking it up will start the Boss Rush. The player can still pick up one of the pedestal items.

Black Market

• Black Market can no longer be accessed in The Chest and The Dark Room, and therefore cannot be used to collect more items.

Treasure Room

• There's a rare chance that a treasure room might contains two items to choose from, only one of which can be taken.
• Treasure rooms may also contain a restock box, allowing Isaac to re-roll offered items if he has coins or bombs.
• New layouts:

Other

• When not having red hearts in Devil Room, the price of items switches to soul hearts.
• Krampus has a new attack pattern.
• The Lost is now unlocked by dying in a Sacrifice Room while holding Missing Poster.
• Sacrifice rooms were reworked to give more useful rewards.