Italian here. Birthdays are special in Italy because there are a lot of cultural traditions that don’t make much sense and they are tied to tradition and superstition. Here are some ideas:
The birthday person must wear a special hat made of garlic and onions. This is said to ward off evil spirits and bring good luck for the coming year.
The birthday person must smash a plate against the wall. This is said to bring prosperity and good fortune.
The birthday person must eat a dozen grapes at midnight. This is said to ensure a year of good health and happiness.
The birthday person must dance with a broom. This is said to bring good luck in love.
The birthday person must wear red underwear on their birthday. This is said to bring good luck in all areas of life.
The birthday person must make a wish while blowing out the candles on their cake, but they must keep their wish a secret. If anyone finds out what the wish is, it will not come true.
The birthday person must cut the first slice of cake with their left hand. This is said to bring good luck.
The birthday person must feed the first slice of cake to the oldest person present. This is said to show respect for elders and to bring good luck to the birthday person.
The birthday person must give out small gifts to all of their guests. These gifts are called "bomboniere" and are typically small candies, cookies, or other treats.
The birthday person must plant a tree. This is said to bring good luck and prosperity.
The birthday person must release a dove into the sky. This is said to symbolize the release of all of the birthday person's worries and troubles.
The birthday person must sing a song at the top of their lungs. This is said to bring good luck and to celebrate the joy of life.