Near Grand Forks, North Dakota, a family is struggling. Middle-aged Gary has a job delivering burial vaults and doing graveside set-ups in a large rural territory. He takes his aging dad with him. But there's something wrong with his daughter CeCe's baby. She isn't growing. Her head's too small. CeCe's on her own with five-year-old Tony and baby Lily while her husband Corey works in the Bakken oil fields, trying to pay off family debts. Failure to Thrive is a portrait of the Upper Midwest in 2008, the Financial Crisis and one family's fall from the hard-won middle class. As Gary tries to hold his family together, navigating CeCe's increasing troubles, he tries to center them on his small plot of land on the Red River, the only land the family has been able to acquire. There he has his chickens and pygmy goats and a shelterbelt of trees to shield him from beet fields and child protective services outside. From his window, he watches the Red River rise and fall each year.