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 0.75x 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. 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 more 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.
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.
Lost Contact: In addition to shielded tears, the fetus is able to destroy projectiles, making it an incredible defensive 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.
Blood Clot: No effect. The baby won't shoot tears with the Blood Clot effect.
Brimstone: The baby charges up the laser, and when released, shoots it and retracts back to Lilith. It should be noted that this item makes Lilith launch the baby less frequently, due to an increase in tear delay.
Chocolate Milk/Tech X: Minimizes delay between launching the baby. When fire button is released fires a shot and returns to Tainted Lilith.
Cursed Eye: The fetus gains the charge effect, but the teleport effect when damaged while charging does not happen.
Epic Fetus: Retracting the baby before the missile falls will cancel the missile strike.
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.
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.
Mega Mush: Tainted Lilith turns into Isaac with black skin. When you shoot the baby, it laughably seems to come out of Isaac's nether regions.
Mom's Knife: The baby carries a knife in his hands that points in the direction of where the tears would be firing, and the baby will no longer retreat back into Tainted Lilith's stomach.
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.
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 Liliths 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.
Tainted Lilith's transition screen portrait.
Closing the game on PC using the Task Manager and reopening it will cause Tainted Lilith to have an additional baby, which is always out of Tainted Lillith's belly. This only adds a baby, and doesn't impact Tainted Lilith's attacks.
Using Mom's Knife and Tiny Planet as Tainted Lilith, while shooting the Mom's Knife charge blast if you recall the baby it will cause the game to crash!