England are missing 19 players this Women's Six Nations - the vast majority through injury. Eight of those were in the team that narrowly lost a World Cup final in November.

His squad is like a robotic movie villain - the hits keep coming but they hardly stumble.

Three uncapped props were involved as England tore through Scotland's set-piece for a 58-7 victory in the opening round.

Middleton says his player pool is testament to the Rugby Football Union (RFU) investment in the women's game.

England have been professional since 2019 and the domestic Premier 15s league began in 2017 with the aim of providing weekly high-level club competition.

"We have gone from having a 30-plus high-quality squad to a 50-plus high-quality squad, and you only see that getting bigger and better," Middleton says.

"We had to work hard to do it. It's the product of a good programme and a good process."

England blaze ahead of the rest

For some, England's injury crisis is a chance to shine. This week, Poppy Cleall's injury means a debut for Bristol lock Delaney Burns.

Centre Tatyana Heard replaced the injured Amber Reed against Scotland to form a successful midfield partnership with Lagi Tuima.

The pair will now start together against Italy, with two such powerful centres promising good ball for England's exciting back three.

Middleton hopes to have Cleall and other key players return for the tougher task of Wales in round three on 15 April.

Centre Reed is hoping to be back by then, as are flanker Alex Matthews, full-back Ellie Kildunne and props Hannah Botterman and Maud Muir.

Some of England's ease with injuries is, of course, down to the lack of competition in the Women's Six Nations.

Although they fell short in last year's World Cup final, their dominance of the European tournament has been total since 2019.

The Red Roses are on the longest winning run in the history of the Women's Six Nations having earned victory in their past 20 games.

Conversely, Italy's record in this fixture carries little joy. The Azzurre have never beaten England and have not scored a try against them since 2018.

While England are years ahead in their professional programme, every other side in the tournament except France has only handed paid contracts to their players in the past two years.

England 'definitely not happy' with goal-kicking

If there is one small crack in the England machine, it is their goal-kicking.

The Red Roses' top-four choices from the tee are all injured with Emily Scarratt, Zoe Harrison and Helena Rowland out for the tournament and Reed missing the Italy game.

England scored 10 tries last weekend and, after Reed left the field and Tuima took on kicking duties, four of those scored were converted.

On Sunday, fly-half Holly Aitchison will take on kicking duties.

Middleton says the side are "definitely not happy with our goal-kicking", adding that a lot of the fault lies in a lack of coaching support for women's players in that area.

Now, England have brought in former Bath fly-half Alex Davies as a kicking coach.

"The girls are practising hard and they need a bit more support from us - that's what we've brought in," Middleton explained.

"It falls to us, not the players."

'Let the chess game begin'

It may be too soon to challenge England, but Italy are a team on the up.

They reached a first World Cup quarter-final last year and challenged France for large parts of their 22-12 loss last weekend.

Former Italy centre Giovanni Ranieri, in his first Women's Six Nations as head coach, has made four changes to that side.

Sofia Stefan moves from scrum-half to the wing to replace the injured Alyssa D'Inca, while scrum-half Sara Barattin, prop Gaia Maris and lock Sara Tounesi are all promoted from the bench to the starting XV.

Marlie Packer - who takes on the England captaincy after Sarah Hunter retired last weekend - told BBC Sport: "You can't knock off with Italy.

"You can do your analysis then turn up on the day and they play a completely different gameplan."

Middleton described Italy as "a really energised side", adding: "In the middle part of the game we were able to overpower Scotland and I think we'll be able to do that against Italy.

"They have got threats around the field and an unpredictability about them.

"They'll have looked at our game and tried to find areas they can get at us. We've tried to fix those up. Let the chess game begin on Sunday."

Line-ups

England: Dow; Breach, Tuima, Heard, MacDonald; Aitchison, L Packer; Carson, Cokayne, Bern, O'Donnell, Burns, Kabeya, Packer (capt), Aldcroft.

Replacements: Davies, Crake, Clifford, Beckett, Robinson, Wyrwas, McKenna, Sing.

Italy: Ostuni Minuzzi; Muzzo, Sillari, Rigoni, Stefan; Madia, Barattin; Maris, Vecchini, Gai, Tounesi, Duca, Sgorbini, Franco, Giordano (capt).

Replacements: Stecca, Cassaghi, Seye, Fedrighi, Locatelli, Stevanin, Busato, Capomaggi.