The A-plot took up most of the episode, but last things first: Alexis Denisof is making good on his promise to check into Rossum, and someone mysterious provides him with information about how the company is making Dolls. Not only that, he tells us he was given "a name," as a contact, presumably, but we don't get to hear who it is. Also, Adelle comes to see Madeline/Mellie/November and encourages/strong-arms her into coming in to the Dollhouse for an overdue "diagnostic." That procedure goes by without a hitch, but when Echo is brought in, freaking out over her "son," Madeline suffers a scratch on her head, and Ballard oversees her being tended to. Madeline is freaked out by the intensity of Echo's emotion, and Ballard in turn is freaked out by Madeline's story about how she joined the Dollhouse because her daughter died of cancer, and how she feels extremely grateful to Adelle for providing her a much-needed escape from her pain.
Topher and Ballard make mention of a "new protocol" he's implemented in Echo that could completely change the way her brain works and cause it to have her body do just about anything. This apparently includes lactating, as the next thing we know, Echo's on a mission as a mother to a newborn baby. The assignment seems strange from the very beginning, as the "husband," "Nate," is distant and weird with both Echo and the baby, and the "friend" to whom Echo complains is none other than Sierra. Echo also notices the black Dollhouse van hanging outside her house all the time, which combined with her extreme sleep deprivation only increases her suspicions that her "husband" is up to something, and when she finds pictures of a strange woman in his office, she thinks he's having an affair. Things worsen when after Echo confronts him, she overhears him trying to call the whole engagement off and misinterprets what's going on yet again, leading to a series of events in which she runs away with the kid ahead of both Nate and Ballard. Nate goes to the Dollhouse and chews out Adelle, who lets us know that Nate hired Echo to nurture his child in his formative months, especially since the loss of his wife, who was the mystery woman in the pictures, left him unable to provide the love the child needed. After Echo goes to the police for help, Ballard and Nate succeed in taking the baby away, but Topher's mindwipe fails, causing him to get clocked in the face, in case the idea causes you pleasure. Ballard realizes that the changes Topher made to Echo on a glandular level caused Echo's maternal instinct to override everything else, which is why she's on her way back to confront her imaginary husband just as he's bonding with his son for probably the first time. In a tense standoff, Nate confesses the truth to Echo about his wife dying in childbirth and blaming his son for his death, and Echo withdraws from the situation without any violence. In the end, though, she once again tells Ballard how she remembers what she felt, and the fact that every mission she goes on feels so real to her is incredibly difficult. Ballard offers to find a way to have her memories really wiped and to go it alone, but Echo prefers to be awake, as she puts it, for whatever's to come.
Ballard walks into Topher's lab and regards the imprinting chair "thought"fully, and after pacing around it nervously for a moment and accidentally hitting a button somewhere on the back, he settles into it, and while he obviously isn't any smarter for being out of the FBI, he certainly is learning how to dress better for being exposed to the Dollhouse. Before I can admire his purple stretchy shirt for long, though, someone he's certainly not getting any fashion tips from, Topher, interrupts to ask him if he'd like a treatment, with a "I'll be here all week!" delivery that seems entirely appropriate. Ballard hops back up and explains that he's tired, and they chat about how Ballard's off-shift at the moment but is having trouble sleeping before Topher presents his ego to Ballard with all the subtlety of a female panda in heat, eagerly asking what he thinks about the "new protocol" in Echo. Ballard allows that it's "different," which is all the encouragement Topher needs to babble about how he blew his own mind just by making one minor change according to a client's request. "I just opened up a whole new world for us." And what did it ever do to you? He "explains" that the "code" he wrote for Echo's brain resulted in changes on a glandular level, and knowing the Dollhouse the first place my mind went was natural boob enhancement. For once, however, Topher seems to have his mind on loftier ideals, saying it might be possible to program the brain to, say, fight cancer or be telekinetic, although he does add, "or not to have that gag reflex when you eat sea urchin," which is certainly gutter-adjacent. Ballard asks if he could do that all to him, but Topher says it could only be achieved with an Active. "I can't fiddle with the mind until it's wiped clean." The fact that he does not follow with the obvious joke at Ballard's expense suggests to me that he's the one that's sleep-deprived. Oh, wait, there he goes -- Ballard says he doesn't understand, and he replies, "But it's so cute that you're trying!" I think now that Boyd doesn't have as much occasion to stop by the lab, Topher's transferred his adversarial man-crush to Ballard. If he invites him into his sleep alcove to play with Fozzie, we'll know for sure. Topher tells Ballard to say hello to Echo...
...who, at the moment, is lying awake in bed next to a gentleman who is neither clothed nor conscious. She gets up, demurely donning a robe on the way, and exits the enormous bedroom and heads down the hall to a nursery, in which she happily greets an absolutely adorable baby boy. She sits and lets him nurse as she sings "Hush Little Baby," and all I can say is that either Eliza is really good with kids or her acting's improved dramatically. I know which one I'm going with. Credits.