Yo, listen up, here's a story
About a little girl that lives in a blue world
And all day and all night and everything she sees is just blue, like her, inside and outside...
The art in the VN is quite charming! You succeeded in making a rotting girl and her sloppily-constructed plushie companion both look cute while also clearly communicating their wretched states, which is impressive~ Kudos to you as well for having everything stand out nicely and in great detail despite it all being blue!
I also like the idea behind the branching routes and multiple endings here, showing different angles and glimpses of the story of what happened with Bobby and Pearl, based on how well or poorly the player helps to motivate her; but honestly, after having gotten all of the endings, I think there's an interesting enough central idea here that you might not need to bother with multiple endings~
That is, I believe that, rather than presenting the player with a labyrinth of choices and routes, you could tell a very compelling linear story at a slower pace: Showing more flashbacks as Bobby slowly begins to gain (or lose!) momentum in self-care thanks to her newly-made companion, and tying together events that are currently route-locked into that same timeline to emphasize Bobby's mindset as she improves (or backslides), you know? The flashbacks would also be a great opportunity to develop both Pearl via additional screentime AND Bobby e.g. by showing how warped her interpretation of events is relative to what actually happened between them, etc~
Nevertheless, great work!