In the 10th century, after the period of iconoclasm in Byzantine art, this image became more widely used, possibly developing from an earlier type where the Virgin's right hand was on Christ's knee [REF].
From the Hodegetria developed the Panagia Eleousa (Virgin of Tender Mercy), where Mary still indicates Christ, but he is nuzzling her cheek, which she slightly inclines towards him; famous versions include the Theotokos of Vladimir and the Theotokos of St. Theodore.