The foetal period constitutes a critical stage in the construction and organisation of the mammalian nervous system. In recent work, we have proposed that foetal brain development is supported by bottom-up (interoceptive) inputs from spontaneous physiological rhythms such as the heartbeat (Corcoran et al., in press). Here, we expand this visceral afferent training hypothesis to incorporate the development of top-down (allostatic) control over bodily states. We propose that the brain’s capacity to actively modify and regulate the afferent feedback it receives through interoceptive (and other sensory) channels is crucial for establishing basic forms of agentic control and grounding the distinction between self and other. We further suggest that individual differences in the way these training regimes are implemented (or disrupted) might impact developmental trajectories in gestation and infancy, including the potentiation of neurobehavioural impairment and disease risk in later life. This analysis raises the important question of whether the deleterious effects of prenatal adversity (e.g., premature birth) can be mitigated via targeted visceral afferent training interventions.