Lil Spewer

Lil Spewer is an unlockable passive item added in The Binding of Isaac: Afterbirth † (Booster Pack #5).

Effects

Spawns a random pill.
Spawns a small Spewer familiar that charges up and fires different types of creep.
The familiar and his creep change randomly when Isaac uses a pill.
Possible creep includes:
- A line of damaging green creep that deals 0.4 damage per tick (12 damage per second).
- A long line of slowing black creep.
- A line of short-lasting, damaging red creep, with a larger puddle of creep at the end that lasts longer. The creep will deal 1.2 damage per tick (36 damage per second).
- A short-ranged cone of damaging yellow creep that grows larger and deals more damage the further it travels. It deals 2 damage per tick at the lowest range, and increases to 15.2 damage per tick at the furthest (~6-47 damage per second, based on range).
- A large ring of long-lasting slowing white creep.

This item has a 1% chance to drop when defeating Blastocyst.
Lil Spewer always starts with green creep.
The familiar does not do contact damage.
Familiars that follow behind Isaac have a certain priority in how close their position is to him over other familiars, with Lil Spewer having 5th / 7th priority.
The Ipecac shot created by Torn Card works for unlocking the Lil Spewer achievement.
The explosive shots from the wisps summoned by Bob's Rotten Head and the Book of Virtues count for the Lil Spewer achievement

Baby-Bender: Has no effect on Lil Spewer.
BFFS!: Increases Lil Spewer's size and creep pool length (but has no effect on damage).
Box of Friends: Creates a random spewer rather than copying the current one.

Lil Spewer is based on this Steam Workshop item by Strawrat and CupertinoEffect.
The item originates from Edmund Mcmillen's previous game of the same name, in which Spewer could consume pills to give his vomit different effects.
Lil Spewer was first revealed in a tweet made by Edmund McMillen as an official item for Booster Pack 5.
In his black form, Lil Spewer resembles Gish, who creates similarly-slowing black creep.
In his red form, Lil Spewer has a similar appearance to Super Meat Boy, from the Edmund McMillen game of the same name. In his title, Super Meat Boy also creates blood (the intended resemblance of red creep).