The Ladder"Building bridges"

• Allows Isaac to walk over gaps with a width of one tile.
TYPE: PASSIVE
ITEM POOL: SHOP
isnt an afterbirth a placenta
do one on behalf of jamal
>no Keeper
Bebop confirmed pleb.
Whóre of Babylon"Curse up"

• When you only have half a heart remaining or less, you enter a curse state which adds +1.5 damage and +0.3 speed.
• When playing as Eve, this item activates with one FULL heart remaining or less AND also removes her 0.75 damage multiplier, raising it up to 1.0.
• The effect is permanently active for characters with no red hearts (e.g. Blue Baby, The Lost).
• One of Eve's starting items.
TYPE: PASSIVE
ITEM POOL: DEVIL ROOM
take poop away from him and give it to me
The Poop"Plop!"

• Drops a poop on the floor.
• Blue Baby starts with this item.
• Can be placed next to a pit and exploded to make a bridge.
• Can be placed over a broken red poop to overwrite it, causing it to no longer regenerate.
TYPE: ACTIVE
RECHARGE TIME: 1 ROOM
ITEM POOL: ITEM ROOM
The Mind"I know all"

• Gives Isaac a full mapping effect, revealing the entire floor and locations of all secret rooms.
UNLOCK: Unlock this item by beating Satan with The Lost.
TYPE: PASSIVE
ITEM POOL: ITEM ROOM, ANGEL ROOM
Tammy's Head"Reusable tear burst"

• Fires 10 tears in a circle around Isaac.
• Each tear is equal to your damage stat + 25 flat damage.
• The tears spawned from Tammy's Head retain tear effects of Isaac's tears, such as poison or homing.
• Synergizes extremely well with Brimstone due to how the damage from both items is calculated when combined.
TYPE: ACTIVE
RECHARGE TIME: 1 ROOM
ITEM POOL: GOLD CHEST
Rainbow Baby"Random buddy"

• A familiar the follows Isaac and fires random tears.
• Rainbow Baby's tears can choose from any of the other familiars, such as homing, spectral, tar shots etc.
TYPE: PASSIVE, FAMILIAR
ITEM POOL: ITEM ROOM
Sacred Heart"Homing shots + DMG up"

• Tears are now white, do a lot more damage and move slower across the screen with a homing effect.
• Health Up.
• Damage Up (damage * 2.3 + 1).
• -0.4 Tears Down.
• -0.25 Shot Speed Down.
• +0.375 Range Up.
• +0.75 Tear Height.
• Full red heart heal.
TYPE: PASSIVE, TEAR MODIFIER
ITEM POOL: ANGEL ROOM
I hope I get sad onion
edit: too late
Dark Bum"He wants to take your life"

• A familiar beggar similar to Bum Friend that follows Isaac and collects red hearts, giving Isaac soul hearts or spiders in return.
• Soul hearts are the most common payout with only a small chance to spawn friendly or hostile spiders.
• Dark Bum has a small chance to give a black heart instead of a soul heart.
• For every 1.5 red hearts he takes, he will give 1 heart/spider in return.
In Afterbirth this is one of the 3 items required to create the Super Bum familiar transformation.
TYPE: PASSIVE, FAMILIAR
ITEM POOL: ITEM ROOM, DEVIL ROOM
Immaculate Conception"Feed them love"

• After picking up enough hearts, Isaac gains a permanent angelic familiar.
• Possible familiars include: Holy Water, Guardian Angel, Sworn Protector, The Relic and Seraphim
• It is possible to get multiple followers by continuing to pick up hearts.
• This item is the angelic counterpart to Cambion Conception.
UNLOCK: Unlock this item by beating Boss Rush with Lilith.
TYPE: PASSIVE
ITEM POOL: ANGEL ROOM, GREED MODE ANGEL ROOM
The Left Hand"The left hand path reaps dark rewards"

• Replaces chest spawns with red chests.
UNLOCK: Unlock this item by beating Ultra Pride.