The Binding of Isaac: Rebirth

Libra has ruined at least a handful of my runs already.

Chocolate Milk is actually pretty good now, btw. I'd say it's almost as good as Poly if you can get a couple tear-ups.

4 Orbitals can only be achieved with Big Fat Fan, otherwise you're limited to 3.

Soy Milk then Libra is the best combo ever. Soy Milk's massive damage reduction is reverted but you keep your tear speed. It's ridiculously OP, but you need to get Libra after you get Soy Milk or it doesn't work.

I never get Chocolate Milk unless I have low tears as it is...so I never grab it. I have more problems getting Ludivico Technique, and I always do terrible with it in the end.

Big Fat Fan explains 4 Orbitals. I still have to get a Guppy run to see how the flies change really affects things.