She starts with one red heart container and 2 black hearts. Like Normal Lilith, she can't fire tears. Instead of tears, Tainted Lilith launches a demonic baby attached via umbilical cord out of her stomach that behaves much like the Gello item that can be recalled after attacking, dealing 3x damage to enemies it hits. The Baby also fires tears that deal 1x damage while the fire button is held, and moves in the direction of the fire buttons; it does not deal contact damage when firing tears. The baby shoots in all directions even without items like Analog Stick and automatically aims at nearby enemies. It returns to Tainted Lilith once the fire button is released. Despite its appearance, the Baby cannot pick up items, but it can be used to launch or push items towards Tainted Lilith.
Tainted Lilith's special attack method is not an item and cannot be rerolled.
Because of the special attack, Tainted Lilith starts with many perks that other characters would heavily benefit from: the launched baby has high starting damage, piercing, and the ability to attack through obstacles. However, this comes at the cost of Tainted Lilith's tears being much harder to use since it is tied to her baby, and the baby's umbilical cord gives its launching attack limited range.
Tainted Lilith's launched baby is enough to one/two-shot most starting enemies, while the tears it fires are comparatively hard to control. It is usually best to use the baby as a makeshift melee weapon for clearing rooms unless Tainted Lilith can find some useful tear modifiers.
When launched, the Baby deals 3x damage and is capable of pushing enemies and bosses away on contact, making it handy to simply hit enemies with the Baby rather than its tears. As such, a high tear rate does wonders for Tainted Lilith, as this also increases how quickly the Baby can be launched from her. However, an overly high tear rate could be detrimental, as spamming the special attack causes the Baby to return before it can hit any enemy.
If the situation calls for it, the baby's tears can be used to safely attack at a distance as an extension of Tainted Lilith. However, this does not usually have use apart from very large rooms since the baby goes through obstacles.
The hitbox of her special attack persists between rooms, meaning that launching the Baby right before entering a room can potentially hit an enemy there.
For early floors, prioritize getting speed upgrades over other stats. While the baby gives Tainted Lilith strong attacking power, it has to be relaunched each time, and her problematic base speed allows chasing enemies to easily overwhelm her. Look to get items that increase speed and avoid those that lower it further.
During later floors, prioritize tear upgrades or range over other stats. At that point, using tears becomes a priority, since some bosses like Delirium are able to teleport constantly, making it hard to use the baby's launch attack on them. Tainted Lilith usually has to resort to her baby's tears to deal consistent damage to these bosses.
The baby cannot collect pickups, but it can knock them around. This ability can be used to dislodge pickups that would normally require you to walk over spikes to get.
Tech X: Holding down the fire button will automatically charge then shoot random size Tech X shots towards enemies.
BFFS!: Increases the damage of the fetus' tears, but the launch attack is unaffected.
Dead Eye: While tears fired from the fetus affect Dead Eye, the whip attack does not. Provided your tear rate isn't too high, you can get the maximum bonus with its tears, then only use the whip attack from then on. Quickly press-and-release the fire button to ensure the fetus doesn't fire an unwanted tear.
Eye of the Occult: Tears fired from the fetus behave as expected from Eye Of The Occult, but the damage and tear rate increase from the item still apply to the initial launch.
Guillotine: Normally with guillotine, tears originate from the rotating head which can be difficult to aim accurately with, but with Tainted Lilith the fetus still fires from Lilith's body with the increased damage, negating the general downside from this item with other characters.
Lost Contact: In addition to shielded tears, the fetus is able to destroy projectiles, making it an incredible defensive option.
Mom's Knife: The baby holds and auto-fires Mom's Knife towards enemies, though the baby no longer automatically returns into Tainted Lilith's stomach. The piercing of the knife allow it to deal damage multiple times per second, which, coupled with the knife's high base damage, make it an extremely powerful offensive option.
Proptosis: The whip attack gains full benefit of the 3x damage multiplier with no downside. The fetus' tears behave as expected, which means they could deal much more damage at middle-long range.
Technology: The fetus's shots instantly hit the nearest enemy, regardless of range.
The Inner Eye: Lowers Lilith's tear rate and doesn't triple her familiar. However, her familiar will shoot a triple shot.
Ipecac: Greatly increases the launch damage of the baby. If the fire button is pressed very briefly, the baby can be launched without also firing an Ipecac tear, allowing the player to attack with high damage, with no risk of hurting themselves from the explosion.
Lead Pencil: Tears are fired from Lilith every 15th launch attack.
The Ludovico Technique: Spawns a Ludovico tear when Lilith launches the baby. The tear disappears when the baby returns to Lilith's belly. The tear works as normal using arrow keys, but is impossible to control precisely with mouse and not at all with the analog stick.
Marked: The baby will not return to Lilith's stomach, and will try to follow where the Mark is. The baby will return when Marked is deactivated with the Drop button.
Monstro's Lung: Like Brimstone, the baby charges up, and when released, shoots Monstro's Lung shots. Greatly increases delay between being able to launch the baby.
Spirit Sword: The baby wields a sword that can be swung multiple times before returning to Lilith. If the fire button is held, the sword will deal damage once before disappearing until the baby is sent out again. The spin attack functions normally, but will immediately return the baby. The sword swing being able to collect pick-ups means Lilith will be able to collect pick-ups and open chests from very far away.
Stye: Stye-affected tears have a chance to fire from the baby, unaffected by luck.
Tractor Beam: Tears will begin firing in front of Tainted Lilith from the point where the baby would reach furthest out, regardless of the baby's current location.
The achievement for unlocking Tainted Lilith is "The Harlot", a possible title for the character.
A "harlot" is a prostitute, or a woman who has many casual sexual encounters or relationships. This is in reference to Lilith's promiscuous tendencies to have intercourse with demons in the underworld outside the garden of Eden.
Written in a Middle-Age satirical book of tales titled the Alphabet of Sirach, we find information that Lilith was Adam's first wife: the evil counterpart to Eve. Whilst Eve promised to be forever subservient to Adam following God's demand, Lilith refused. In particular, the tale mentioned tells us that Lilith would often escape the garden of Eden in order to have intercourse with demons in the underworld — in particular, with the Devil himself. A good theory suggests that the game refers to the results of Lilith's promiscuous life in the underworld due to her appearance, according to this satirical tale.
In Rabbinic Literature and other non-satirical tales, we find information that Lilith was, more specifically, a generic demon that brought curses upon the newborn. This is another viable theory, given Tainted Lilith's appearance in-game.
The character select screen description for Tainted Lilith, "Fetal Fury", is possibly a reference to fighting game series Fatal Fury.
Defeating Greedier mode as Tainted Lilith unlocks II - The High Priestess?, associated with passion, strong emotions, and individual opinions, these all fit Lilith's character when she rejected God's plan in the garden of Eden to lead a promiscuous life in the underworld.
Tainted Lilith's transition screen portrait.
Tainted Lilith's locked character icon, depicting a Closet doorway full to bursting
If the player is able to generate lots of projectiles (such as through the use of Almond Milk, Haemolacria, and Trisagion) Lilith will sometimes take damage upon launching or retracting the fetus.