In a medium saucepan, boil the macaroni until cooked. Drain well. In a large saucepan over medium heat, melt butter then add flour stirring constantly until a smooth paste forms. Slowly add PediaSure Grow and Gain Vanilla, continuing to stir constantly until well-blended and smooth (do not boil). Remove from heat. Add salt, pepper, cheese and cooked macaroni to the PediaSure mixture and mix thoroughly. Serve immediately.
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