Cain
ReadyHold 55 coins at the same time.
Achievement
Defeat Delirium as Cain.
In-game: “Unlocked a new item.”
Sources:AchievementsThe VoidDelirium
Hold 55 coins at the same time.
Defeat Mom.
Reach Depths II and defeat Mom.
Sources:AchievementsWomb
Defeat Mom's Heart 10 times.
After: The Womb
Defeat Hush.
After: The Womb, Blue Womb
Defeat Delirium as Cain.
After: Cain, The Womb, Blue Womb, New Area