BFFS! 
Effects
- Visually increases the size of all familiars by 25%, and improves the effectiveness of most of them.
- Doubles the damage of Familiars that deal damage through tears and contact damage.
- Has no effect on Creep generated by familiars.
- For pickup-generating familiars, increases the frequency that they drop pickups.
- Familiars that require clearing a certain number of rooms will require one less room.
- Familiars that have a random chance to drop items have a higher chance.
- Familiars that pick up consumables require less, except
Dark Bum which is unaffected.
- Some familiars have unique synergies.
Notes
- The size change is only cosmetic: familiars' hitbox for blocking damage or attacking is not affected.
- Familiars summoned by a trinket or by
Monster Manual are also affected by BFFS!.
- The Blue Flies and Blue Spiders benefit from
Hive Mind instead.
- Does not increase the frequency or effectiveness of Status Effects applied by familiars.
Synergies
BBF/
Bob's Brain: Doubles impact damage and increases explosive damage by 25.
- (Added in Repentance)
Bird Cage: Spawns 4 rock waves in an x pattern. Doubles the damage when the bird lands and doubles contact damage. Damage of waves unaffected.
- (Added in Repentance)
Blood Oath: Adds 2 extra full hearts worth of bonuses if any health is drained.
- (Added in Repentance)
Holy Water: Double water damage, spawn a blue flame at point of impact.
- (Added in Afterbirth)
Incubus: Shoots tears that do (Removed in Repentance) 2x Isaac's damage (Added in Repentance) 1.5x Isaac's damage. Still deals 2x as (Lilith) Lilith.
- (Added in Repentance)
Isaac's Heart: Fires additional shots in random directions and leaves a larger puddle of creep. Does not change the heart's size.
Juicy Sack: Spawns an extra Blue Spider.
- (Added in Afterbirth †)
Lil Spewer: Increases the creep pool's size, but not its damage.
- (Added in Repentance)
Lost Soul: Gives the Lost Soul a
Holy Mantle effect.
- (Added in Afterbirth †)
Mystery Egg: Spawns a champion variant of an enemy, even if the enemy normally can't be a champion.
- (Added in Repentance)
Stitches: On use, fires eight tears from Isaac's original location. The tears synergize with Isaac's tear effects.
Interactions
- (Added in Repentance)
Blood Puppy: Only increases the damage and size while it isn't hostile.
- (Added in Afterbirth)
Evil Eye: The eyes are not treated as familiars and therefore will not synergize with BFFS!
Guillotine/
Scissors: Doesn't change the head's size, but still improves its damage.
- (Added in Repentance)
Hive Mind: Does not stack.
- (Added in Afterbirth †)
Shade: Retains the increased damage even after being absorbed.