The Binding of Isaac: Afterbirth/Changes

Characters

 * Azazel
 * His mini-brimstone's range can be increased with range up items or pills.
 * The Lost
 * He is unlocked by dying in a Sacrifice Room while holding Missing Poster.

Activated Collectibles

 * The head deals 3 times Isaac's tear damage as poison over time instead of either 6 or 8 points.
 * Increases the chance to open the Devil Room or Angel Room by 12.5% after killing a boss while holding it instead of guaranteeing it.
 * Increases chance for a Devil/Angel Room Door to open by 17.5% instead of 35%.
 * Knocks back enemy shots.
 * The beams have a high chance to directly target enemies.
 * Previously held items are removed from the pause menu.
 * 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.
 * Fly enemies are only rerolled into other fly enemies.
 * Red flies can't be rerolled anymore (even though enemies can be rerolled into them).
 * 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.
 * Can no longer be used without red heart containers.
 * Has a 50% chance to rotate all beams around the player 90 degrees, similar to Krampus' second Brimstone attack.
 * Sprite changed.
 * Does not affect if Monstro is in the room the item is used in.
 * Knocks back enemy shots.
 * Its recharge time is 2 rooms instead of 6 rooms.
 * Dark Room can no longer be cleared repeatedly.
 * 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.
 * Can no longer be used without red heart containers.
 * Has a 50% chance to rotate all beams around the player 90 degrees, similar to Krampus' second Brimstone attack.
 * Sprite changed.
 * Does not affect if Monstro is in the room the item is used in.
 * Knocks back enemy shots.
 * Its recharge time is 2 rooms instead of 6 rooms.
 * Dark Room can no longer be cleared repeatedly.
 * Does not affect if Monstro is in the room the item is used in.
 * Knocks back enemy shots.
 * Its recharge time is 2 rooms instead of 6 rooms.
 * Dark Room can no longer be cleared repeatedly.
 * Its recharge time is 2 rooms instead of 6 rooms.
 * Dark Room can no longer be cleared repeatedly.
 * Dark Room can no longer be cleared repeatedly.

Passive Collectibles

 * Sprite changed.
 * 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 changes.
 * If a run is quit, and then continued, 3 Dollar Bill will keep tear effects for the current room.
 * Shoots tears towards Isaac regardless of which direction Isaac is shooting.
 * Blocks enemy shots.
 * Bob's Brain is fired directly from where it is located in the chain of familiars behind Isaac, making aiming it slightly more difficult.
 * Each copy takes up its own spot on the familiar line, but only the first one launches out. Respawning brains may end up stacking on top of each other.
 * Can drop a Golden Bomb.
 * Can drop a Golden Bomb.
 * Heals Brownie, Dangle, and Dingle.
 * Each tear deals Isaac's tear damage.
 * The poison hits twice, dealing a total of double Isaac's damage.
 * 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.
 * Isaac gives a wide glow lighting up dark areas, such as those under the effects of the Curse of Darkness or the Dark One's attacks.
 * Brimstone shots damage the heart.
 * Nullifies effects of One Makes You Small pills, One Makes You Larger pills, and other items that decrease the size of Isaac, such as Caffeine Pill.
 * Gives a shield to familiar's tears.
 * Speed boost is applied immediately.
 * Range and tears height buffs are applied immediately.
 * If picked up twice in the same run, two knives are fired at once.
 * Dies after taking too much damage and then respawns after a long time. Exiting and continuing the run will cause it to reappear right away.
 * Dies instantly by enemies' beam-type attacks, such as Uriel's and Gabriel's beam. This also includes enemies' Technology lasers such as Eye and Camillo Jr..
 * Reappears instantly each time a familiar or orbital item is picked up.
 * The poison hits twice, dealing a total of double Isaac's damage.
 * 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 slow is only applied after the player is hit.
 * Isaac's bombs are magnetically attracted to the player character's tears.
 * The laser can have the effect of Mysterious Liquid or Rubber Cement.
 * 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.
 * Gives a shield to familiar's tears.
 * Speed boost is applied immediately.
 * Range and tears height buffs are applied immediately.
 * If picked up twice in the same run, two knives are fired at once.
 * Dies after taking too much damage and then respawns after a long time. Exiting and continuing the run will cause it to reappear right away.
 * Dies instantly by enemies' beam-type attacks, such as Uriel's and Gabriel's beam. This also includes enemies' Technology lasers such as Eye and Camillo Jr..
 * Reappears instantly each time a familiar or orbital item is picked up.
 * The poison hits twice, dealing a total of double Isaac's damage.
 * 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 slow is only applied after the player is hit.
 * Isaac's bombs are magnetically attracted to the player character's tears.
 * The laser can have the effect of Mysterious Liquid or Rubber Cement.
 * 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.
 * Causes the Deals with the Devil not to convert the heart-type automatically.
 * The slow is only applied after the player is hit.
 * Isaac's bombs are magnetically attracted to the player character's tears.
 * The laser can have the effect of Mysterious Liquid or Rubber Cement.
 * 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.
 * The laser can have the effect of Mysterious Liquid or Rubber Cement.
 * 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.
 * Enemies killed after they have been inflicted with this type of poison have a 20% chance to drop Black Hearts.

Trinkets

 * Match Stick
 * Can replace the Tick.
 * Missing Poster
 * 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 the 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.
 * Mysterious Paper
 * Small chance to revive Isaac as The Lost upon death, like Missing Poster.
 * Tick
 * Can be replaced by Match Stick.

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 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.

Monsters

 * Bony
 * Only leaves behind bones when killed.

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
 * Can contain a Bed, a Key Master and 3 hanging dead Shopkeepers.
 * New layouts:


 * Angel Room
 * Possible rewards found in the room include:
 * 2 Eternal 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 apply the 25% bonus.
 * Donating to a 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.


 * Curse Room
 * Can contain Reward Plates, cards, runes, Black Globin's Heads, Imps, and/or Nulls.


 * Challenge Room
 * The three waves appear in random orders rather than the original orders.


 * Sacrifice Room
 * The payouts only depend on the number of sacrifices made. The number of sacrifices is reset to 0 when the player goes to the next floor.
 * Rewards are reworked:
 * Losing red hearts due to the spikes will reduce the chance for a Devil Room to appear.
 * The amount of luck that the player has does not affect the payout probabilities.
 * Angels are normally able to fly over spikes but will take damage from sacrifice room spikes.
 * New layouts:


 * Secret Room
 * Can contain 2 Reward Plates.


 * Shop
 * There is a small chance when you bomb the Shopkeeper that they can turn into Greed and start attacking you.


 * Super Secret Room
 * The Dark Room theme contains 4 Nulls and 6 pills or runes instead of 1 Black Heart.
 * New themes:
 * Burning Basement: 2 Bomb Chests, a Shopkeeper, 3 TNT, and Fire Places, including Red Fire Places.
 * Flooded Caves: black poop and spikes.
 * Library: 1 Black Heart.
 * I AM ERROR: A Mom's Hand, random pickups, chests, cards, and trinkets.


 * Treasure Room
 * There's a rare chance that a treasure room might contain two items to choose from, only one of which can be taken.
 * Treasure rooms may also contain a Restock Machine, 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 floor icons on the stage transition sprites are updated; instead of being large rectangles with the unknown ones being grey, the sprites feature a much thinner and more detailed border with the unknown floors being represented by a closed trap door.