For the pudding: Heat the milk, cream and sugar in a medium saucepan over medium-low heat. Heat until just barely simmering, then remove from the heat.
Meanwhile, melt the 10 tablespoons butter in a medium pot. Sprinkle the flour evenly over the butter and cook, whisking constantly, until the mixture browns lightly and smells nutty, 3 to 4 minutes.
Gradually ladle the warm milk mixture into the pot, whisking constantly, until incorporated and the mixture comes to a visible simmer and thickens, 3 to 4 minutes.
Remove from the heat and stir in the vanilla extract.
For the spiced sugar: Combine the sugar, cinnamon and nutmeg in a small bowl and stir. Set aside.
Serve the pudding warm, drizzled with melted butter and a generous sprinkling of the spiced sugar.