Binding of Isaac: Rebirth Wiki

Added in Afterbirth

Immaculate Conception is an unlockable passive item added in The Binding of Isaac: Afterbirth.



  • All types of hearts except Gold Heart Gold Hearts and Added in Afterbirth † Blended Heart Blended Hearts count.
  • Items that directly add health such as Yum Heart Yum Heart, Book of Revelations Book of Revelations, Satanic Bible Satanic Bible, and The Nail The Nail do not count towards spawning a familiar.
  • Only one of each type of familiar can be spawned.
  • The Lost The Lost can pick up Soul Hearts and Black Hearts despite having no health and thus can activate Immaculate Conception.
  • Keeper Keeper cannot encounter hearts, thus the item is useless for him.
  • As the short-lived Half Red Hearts dropped by Tainted Magdalene Tainted Magdalene also count, it is an excellent choice for her since she will constantly be picking up hearts and gain all five familiars quickly.
  • The familiars spawned by Immaculate Conception will still spawn even if Isaac has already obtained the familiar through their respective pedestal item.


  • The Jar The Jar: Hearts collected in the jar do not count towards activation.

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