Happy Birthday traditions

One tradition that is relatively familiar to me is getting a cake and singing “Happy Birthday”. However, I wonder what people used to do before the song was created. After looking it up, the song was created in 1893, so it has been around for a while. After some more searching on the internet, seems like cake and candles were still popular for birthdays, while the songs were from greetings, poems, or local songs. Some people I talked to mentioned that they eat foods that represent longevity and wish for health and wealth. I think it’s pretty cool that there is a universally recognized birthday song. Are there any birthday traditions that you like in particular? Are there any universally recognized traditions that you participate in? Are there any traditions that should be universally recognized?