I wouldn't say you need health pickups. The game is perfectly playable without them, and it does give the gameplay a unique flavor for a metroidvania. I didn't particularly dislike it.
It just seems weird to only take that survival horror-style approach for health pickups, while leaving in all the other usual drops from enemies you'd see in a Metroid game. An alternative where you only restock bombs, bullets etc at save points like it's Dark Souls could be pretty interesting.