Binding of Isaac: Rebirth Wiki
Binding of Isaac: Rebirth Wiki
Head   Trauma
Character Isaac appearance.png
Full red heartFull red heartFull red heart
Table dividing line 1.png
Challenge Number
Available Rooms
Item Pool Treasure Room.png: no          Item Pool Shop.png: yes
Boss Mom.png

Head Trauma is challenge #3. Isaac starts this challenge with 15►Tiny Planet Tiny Planet, 15►Soy Milk Soy Milk, 15►The Small Rock The Small Rock, and 15►Iron Bar Iron Bar. The goal is to defeat Mom. This challenge is unlocked by default.


  • Tiny Planet and Soy Milk will make it very difficult to target enemies. Isaac will inflict only small amounts of damage, and increasing that damage will prove near impossible.
  • Iron Bar can also up the difficulty as the unpredictable movement of confused enemies can make them harder to hit.
  • As Tiny Planet makes it impossible to predict how a tear will hit an enemy, it is much harder to prevent knocking an enemy into Isaac.


  • Since targeting enemies is difficult, it may help to learn where Isaac's shots converge in front of him. Practice will be a big factor.
  • While it is possible to strike enemies directly behind Isaac, this has an increased chance of enemies being pushed towards Isaac.
  • Rapidly hitting left and right to shoot tears will cause a better spread of tears around Isaac and make it easier to hit enemies.
  • Bombs are much less effective in battle, as tears can erratically move them around the room before detonation. Bombs should not be used for any reason until all of Isaac's tears have disappeared.
  • Finding Krampus is highly valuable, as obtaining 15►A Lump of Coal A Lump of Coal results in a significant damage increase since Isaac's tears spend a long time on screen.
  • Iron Bar can cause enemies to stop targeting Isaac while they're dazed, allowing some additional freedom of movement and extra time to improvise strategies.
  • Fear effects will make enemies much easier to target, as they will run in a straight line away from Isaac. This allows Isaac to drive them against a wall and target them as they become trapped.
  • Transforming into Guppy is a great strategy due to the massive number of Blue Flies that are spawned as a result. It is possible to use this transformation to effectively triple Isaac's damage output.
  • It is possible to encounter an impossible room, due to enemies being too far away to reach with Tiny Planet. All rooms unlock by default after 2 minutes have passed.
    • Ring Worm Ring Worm causes tears to fly around uncontrollably but can make it easier to hit faraway enemies.
  • 15►Polyphemus Polyphemus will turn tears into giant tears, effectively doubling damage without affecting Tears or Tear Speed.
  • 15►Lost Contact Lost Contact will turn tears into massive shields that, combined with Tiny Planet, will make Isaac nearly completely invulnerable to ranged attacks.
  • Removed in Repentance 15►Libra Libra will greatly boost Soy Milk's damage output.
  • Removed in Afterbirth † Due to the severe damage lowering effect of Soy Milk, rerolling Isaac's passive items is a viable strategy. This makes the 15►D4 D4, the 15►D100 D100, 15►Missing No. Missing No. and 1 or 6 pip Dice Rooms valuable.
  • 15►Brimstone Brimstone dramatically reduces the difficulty of the challenge. While overall damage is still low, it is far easier to aim, and it can be fired with no charge-up time.
  • Added in Afterbirth15►Tractor Beam Tractor Beam allows for a much greater degree of control over Isaac's tears, eliminating the difficulty provided by Tiny Planet.
  • Because of Isaac's high Tears stat, items that have a chance to cause harmful effects upon hit (such as Added in Afterbirth15►Holy Light Holy Light, 15►Fire Mind Fire Mind or 15►The Common Cold The Common Cold) are valuable.

Unlockable Achievements[]

MainPageChallenges.png Challenges MainPageChallenges.png

1. Pitch Black 2. High Brow 3. Head Trauma 4. Darkness Falls 5. The Tank 6. Solar System 7. Suicide King
8. Cat Got Your Tongue 9. Demo Man 10. Cursed! 11. Glass Cannon 12. When Life Gives You Lemons 13. Beans! 14. It's in the Cards
15. Slow Roll 16. Computer Savvy 17. Waka Waka 18. The Host 19. The Family Man 20. Purist
21. XXXXXXXXL 22. SPEED! 23. Blue Bomber 24. PAY TO PLAY 25. Have a Heart 26. I RULE! 27. BRAINS!
28. PRIDE DAY! 29. Onan's Streak 30. The Guardian
Afterbirth †
31. Backasswards 32. Aprils Fool 33. Pokey Mans 34. Ultra Hard 35. Pong
36. Scat Man 37. Bloody Mary 38. Baptism by Fire 39. Isaac's Awakening 40. Seeing Double 41. Pica Run 42. Hot Potato
43. Cantripped! 44. Red Redemption 45. DELETE THIS
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