On the name entry screen, enter your name as "frogmode". When starting the game, Ittle will be replaced with a frog and start with only one heart instead of five. This is effectively hard mode. This also changes cutscenes, "Ittle" will have no dialogue and occasionally says nihilistic things instead.
Name your save "jennyberry" and you will start the game as a Jenny Berry from Ittle Dew One! This will also turn Tippsie into a flying ice cream cone.</p>