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You may want to save up your coins for devil deals, making sure you have at least 15 or 30 before a boss fight can help you buy deals to help beef him up during runs.
Also compete the Pong challenge, that unlocks you Greed's Gullet, which allows you to gain a lot more health slots for Keeper.
Also battery items are your friend.
Anyhow, my solution is just to not play him, because I don't have fun with him. Having to backtrack constantly--especially the end-of-floor backtracking to vacuum up all the coins I left earlier makes runs with him slow and plodding. Sure, you end up doing some cleanup with most characters at times, but that's usually to squeeze some benefit out of extra hearts or something and not just to grab like five cents. Given his abysmal tear rate, I find the biggest problem with him is getting bored and making mistakes. Shooting extra tears makes up for that a little bit with big enemies but not nearly so much with many small ones. I will say that I had a pretty good time with him once when I got Neptunus--of course that's not saying much because it's a good item. I wouldn't encourage you to skip treasure rooms trying for that item, but if you're forced to skip one that might be a nice booby prize.
Since you don't really have the option not to play him since you need unlocks, my suggestions are to get those game-changing unlocks (third heart, wooden nickel) out of the way. I think he plays far better once you have a somewhat reliable source of health plus an extra hit buffer--Curse rooms become usable and Sacrifice rooms aren't as annoying to use, plus you can more safely gamble on Boss Challenge rooms with the chance of regaining a second hit point from the Nickel. Of course that's not very useful advice--I don't actually have any.
Beelzbub
purple defense fly
pig savings container
AHJC
WLYH
I got killed by the last horsemen, dam it, but it was a good run