Binding of Isaac: Rebirth Wiki
Have   a   Heart
Character Isaac appearance.png
Full red heartEmpty red heartEmpty red heartEmpty red heartEmpty red heartEmpty red heart
Empty red heartEmpty red heartEmpty red heartEmpty red heartEmpty red heartEmpty red heart
Table dividing line 1.png
Challenge Number
Starting Items
Charm of the Vampire Charm of the Vampire
Available Rooms
Item Pool Treasure Room.png: yes          Item Pool Shop.png: yes
Boss Mom's Heart portrait.png
2 new pills 2 new pills
Unlock Method

Have a Heart Defeat Mom

Added in Afterbirth

Have a Heart is challenge #25. Isaac begins the challenge with Charm of the Vampire Charm of the Vampire and 12 Red Heart containers, but only one of them filled. Unlike in many other challenges, Treasure Room Treasure Rooms and Shop Shops are available. The goal is to defeat Mom's Heart Mom's Heart / It Lives It Lives.


Charm of the Vampire is the main way to fill Isaac's Red Heart containers (see below for exceptions). All Red Heart Red Heart pickups are replaced with Penny Pennies ( Half Red Heart Half Red Heart = Penny, Red Heart (and Added in Afterbirth † Blended Heart Blended Heart) = Double Penny Double Penny, Double Heart Double Heart = Nickel Nickel) (Added in Afterbirth † though Blended Hearts can still spawn). HP up items (e.g.: Breakfast Breakfast) give Red Heart containers, but do not fill HP. The VI - The Lovers VI - The Lovers card spawns Pennies instead of Red Hearts. The 2 of Hearts 2 of Hearts card and Yum Heart Yum Heart, as well as Added in RepentanceYuck Heart Yuck Heart, create no effect. The Tick Tick will still reduce a boss's health, but will not heal upon entering the Boss Room Boss Room. Shop Shops sell coins instead of hearts. Slot Machine.png Slot Machines, Blood Donation Machine.png Blood Donation Machines, the Hematemesis pill, and any of the Beggar.png Beggars drop coins instead of hearts. Even a Super Secret Room Super Secret Room which usually contains hearts will contain money instead. It is also impossible to recover health with Pyromaniac Pyromaniac or Leech Leech. Added in Repentance This challenge is slightly easier in Repentance, as Charm of the Vampire now gives a small damage up.


The biggest difficulty lies in acquiring health. However, with numerous Red Heart containers, there are several strategies to survive the challenge. First is finding a way to heal Red Heart damage.

  • The Full Health pill is a major boon for this challenge.
    • The Bad Trip pill can also heal fully, but only when at one heart or less.
    • When combined with these pills, the Placebo Placebo becomes very powerful. It can be purchased in Shops.
  • XIX - The Sun XIX - The Sun card also heals to full health, alongside other benefits.
    • Combined with a Blank Card Blank Card, the challenge becomes trivial. This can be purchased from Shops.
    • Added in RepentanceSol Sol's XIX - The Sun XIX - The Sun effect works, granting full health after defeating each floor's boss.
  • Obtaining the Habit Habit or Sharp Plug Sharp Plug from a shop allows Placebo or Blank Card to be used at will without any fear of death (though this may not be the case in Repentance due to these items being revamped).
  • Rainbow Poop Rainbow Poop will also give full health, but it is also very rare.
    • Added in Afterbirth †Bozo Bozo has a chance to create Rainbow Poop when Isaac takes damage, thus picking it up can make the challenge substantially easier.
  • Beds still refill Isaac's health.
  • Added in Afterbirth †Adrenaline Adrenaline is very helpful, as Isaac will have multiple empty Red Heart containers.
  • Blowing up a Shopkeeper Shopkeeper counts as killing an enemy.
  • Should you happen to get a summon-based boss like The Duke of Flies The Duke of Flies early, you can use the minions it summons to farm life, potentially giving you the equivalent of a full health pill on an early floor.

Second is getting rid of excess Red Heart containers. Removing even one Red Heart container will make obtaining deals with the Devil and Angel Room Angel Rooms much easier, as the open HP spot can hold Soul Heart Soul Hearts/ Black Heart Black Hearts, providing insurance against Red Heart damage.

  • The Devil Room Devil Room or Black Market Black Market deals not only give good items, but also free up space for Soul Hearts. This, naturally, comes with the downside of preventing Angel Rooms from appearing.
    • Abaddon Abaddon can remove all Red Heart containers to be replaced by Removed in Repentance six Black Heart Black Hearts (Added in Repentance twelve) , assuming no heart containers have been lost prior.
  • The Health Down pill can clear away some extra Red Heart containers to allow picking up Soul/Black Hearts. This can synergize with Placebo Placebo nicely.
  • Guppy's Paw Guppy's Paw is one of the more useful items for survival because it removes hard-to-fill Red Heart containers and replaces them with Soul Hearts.
  • Added in Afterbirth †Potato Peeler Potato Peeler can be found in shops and easily removes excess empty Red Heart containers for Cube of Meat Cube of Meats, allowing you to easily get a couple of Meat Boys if desired.

A third method involves grinding enemies to replenish Isaac's health.

  • Mulligan Mulligans and their variants, Sack Sacks, and other spawning enemies can provide limitless sources of enemies to fill health.
  • Getting the D7 D7 and repeatedly clearing a room filled with easy-to-kill enemies can fill Isaac's entire HP bar.
  • The Shell Game can be a useful method of spawning Attack Fly Attack Flies.

Because hearts turn into coins, Shop purchases are easier to make.

Some other things to note:

  • If Isaac is at full health, the boss should take priority. Health lost during the battle can be replenished from unexplored rooms.
  • Avoid using Hematemesis, as it will drain you to one filled Red Heart container without spawning two to four hearts as usual.
  • If Isaac dies with a 1up! 1up!, all Red Heart containers will be filled.
  • Judas' Shadow Judas' Shadow purges all Red Heart containers and leaves 2 Black Hearts.
  • Removed in Repentance Mom's Locket Mom's Locket refills half a heart each time a key is used.
  • Acquiring an Eternal Heart Eternal Heart will allow Isaac to take an extra hit. However, no health will be granted when acquiring a second Eternal Heart or moving to the next floor.
  • Added in Repentance The bleeding mechanic from Added in Afterbirth †Shard of Glass Shard of Glass can be tricky to remove, as red heart healing can be rare. Consider skipping this item if you're having trouble healing.
  • Added in RepentanceQueen of Hearts Queen of Hearts spawns double pennies instead of hearts.


  • 2 new pills
    2 new pills - Complete Have a Heart (challenge #25).
    • The pills unlocked are Re-Lax and ???.