They do a great job as long as you ask them to. We made the mistake of not saying will you please send something to our room for our DD's birthday. However, even though we didn't do that (although I thought I had, and it must be 48 hours in advance), they still did something phenominal for our DD turning 6. When we checked in they gave us a birthday button for her to wear on her birthday, and put her name on it. It garnered lots of attention from the CM's and other park guests. It also got her special attention and autographs from the characters. When by late afternoon the hotel hadn't done anything, although as I said we thought when we checked in our asking if they did anything and having it in our reservation would result in balloons or something like that, my DH asked at the front desk. They said they usually, needed 48 hours, but would see what they could do. Well what they did in about 4 hours was amazing. She got a solid white chocolate Mickey with her name and happy birthday on it and cookies. They also gave her a birthday card and picture signed from Cinderella. She was in seventh heaven and I was so excited for her I called the front desk to profusely thank them. Now we were at the GF, so that may have made a difference, because my understanding it's usually balloons and a picture from the favorite character.
You can book a special dinner wherever you want and just tell them in the reservation and when you check in you have a birthday girl. You can do one of 2 things, request their standard cake for about $12 or just get the birthday cupcake. If you request it (the cake)before you arrive make sure to reconfirm it 48 hours in advance. She will get a special matt, and sometimes confetti and streamers. If you are at a character meal they will have one of the characters come to your table when you get the cupcake (cake) and sing Happy Birthday. We were at Chef Mickey's and so Mickey was at our table with an arm around her while we sang. She loved it. If you go to the Hoop-Dee-Doo they will single her out to the entire audience and maybe even have her participate in the show.
You can also order a specialty birthday cake. You must do it 48 hours in advance. You can pick it up or have it delivered. We ordered her a cake through the GF Bakery and had it delivered to our room. It was not supper cheap since we requested a white chocolate castle and pop-up with Cinderella on it, but it was really nice. My only problem, and from what I have heard others too, was everyone was so full from dinner they didn't eat more then 1/4 of the cake. We even had it delivered at 9:30 p.m., we had a 6:40 reservation, and still no one ate it. If you want to go this route I would almost do a late lunch at like 4:30 and get the cake in the evening so you eat it and it's more worth the money you spend.
I have no doubt if you wanted to bring something down, or buy something special and have the front desk deliver it for you, they would be more then happy to do so. You really just have to ask for what they will do and take advantage of whatever they are willing to offer.
By the way my DD's birthday is March 31st. !