The Red Roses ended their November Quilter Internationals unbeaten after sealing a comprehensive 60-3 10-try win over Italy.
England led 22-3 at the break with tries from Vicky Fleetwood, Poppy Cleall, Heather Kerr and Abby Dow, while Italy's points came via a Michela Sillari penalty.
Second-half tries from Kerr, Emily Scarratt, Sarah Bern (2), Rownita Marston and a penalty try added further gloss to the win.
Middleton’s side made it a 17th straight victory on home soil in front of vociferous support at a sold-out Goldington Road in Bedford, following on from the impressive following at Sandy Park last weekend.
The Red Roses were led out by Natasha Hunt, who celebrated her 50th cap, and having defeated France both home and away in November, they ended their Quilter Internationals with a third victory.
Victory also meant the Red Roses ended 2019 by winning 11 of their 13 games but having established such dominance at home it will be on the road where they begin their Six Nations defence though, taking on familiar foe France on Sunday 2 February in Pau. Fixtures against Scotland, Ireland, Wales and Italy will then follow.
A feature of England’s performances over the past two years under the guidance of forwards coach Richard Blaze has been the dominance of their pack and it was in full evidence during an impressive first half in Bedford.
Italy's resistance lasted less than six minutes, Fleetwood bundling over off the back of a driving maul - which would set the tone for the match.
Sillari had Italy's first points from the tee but England's power up front continued to do the damage and Cleall powered through to cross under the posts, which Scarratt converted.
Another driving maul from a lineout resulted in Kerr bundling over for a third England try and Dow had a fourth when diving over in the corner as Middleton's side showed great patience going through multiple phases before shifting the ball wide to the Wasps FC Ladies wing.
World player of the year Scarratt cut a fine line through the Italy midfield to cross under the posts for a fifth England try after the break and she converted her own score.
Italy lost Lucia Cammarano to the bin as their task was made that much harder and England made them pay, Kerr bundling over off the back of another lineout driving maul.
Italy were powerless to stop England’s driving maul, and Bern powered over for England’s seventh.
England were awarded a penalty try after scrum infringement from Italy as Middleton’s side crossed 50 points.
And moments later the power from the pack was in full evidence again as an England scrum on Italy’s 5m was shunted to their own tryline and Marston dotted down.
Italy lost Sara Tounesi to the bin in the final moments and Bern had a second try after collecting the ball off the top of a lineout and flying down the blindside to cross for a 10th England score.
Vicky Fleetwood was among the try scorers and having been named player of the match, she paid tribute to her fellow forwards.
“We stuck to our principles, played it through the forwards when we needed to and shifted it out to the backs when it was open for them. It as scrappy at times but great to come away with the win," she said.
“Having Sarah Bern and Ellena Perry come on off the bench was massive for us, we’ve built throughout the autumn and have learned from every game and hopefully we can continue to build through the Six Nations."
England – Tries: Fleetwood, Cleall, Kerr 2, Dow, Scarratt, Bern 2, penalty Cons: Scarratt 2, Harrison
Italy – Pens: Sillari
15 Sarah McKenna, 14 Abby Dow, 13 Emily Scarratt, 12 Emily Scott, 11 Claudia MacDonald, 10 Zoe Harrison, 9 Natasha Hunt; 1 Hannah Botterman, 2 Heather Kerr, 3 Shaunagh Brown, 4 Poppy Cleall, 5 Zoe Aldcroft, 6 Marlie Packer, 7 Vicky Fleetwood, 8 Sarah Hunter (C).
16 Amy Cokayne, 17 Ellena Perry, 18 Sarah Bern, 19 Sarah Beckett, 20 Rownita Marston, 21 Leanne Riley, 22 Katy Daley-Mclean, 23 Jess Breach.
15 Sara Barattin, 14 Maria Magatti, 13 Michela Sillari, 12 Beatrice Rigoni, 11 Camilla Sarasso, 10 Micol Cavina, 9 Sofia Stefan; 1 Silvia Turani, 2 Melissa Bettoni, 3 Lucia Gai, 4 Valeria Fedrighi, 5 Giordana Duca, 6 Isabella Locatelli, 7 Giada Franco, 8 Elisa Giordano.
16 Giulia Cerato, 17 Michela Merlo, 18 Sara Tounesi, 19 Valentina Ruzza, 20 Lucia Cammarano, 21 Francesca Sgorbini, 22 Laura Paganini, 23 Beatrice Capomaggi.