We figure out what our children want or need, what our budget is, if we are or are not hosting a party and if it is friends or family, and then that all dictates what they may or may not be getting.
Growing up we sometimes got joint gifts. All our (5 kids) birthdays were in a 3 month window, we sometimes would get the sit down talk "Would you like to do this/have us buy this, and then this trip/item will be a birthday present for all of you?" We got that a lot of years, and we were all perfectly fine with it. We got the combo birthday/christmas gift on occassion as well. Usually it would mean we got to spend a few days at a cabin in Maine and hang out all the beach all day and go wandering around the cliffs and little shops and stuff. If I have to forego a conventional gift or party to do something like that? Hell yeah. Some years we had small homemade gifts for birthdays or Christmas. We knew money was tight or that there were things that money needed to go to over frivolous gifts, and again, it wasn't a problem.
Not getting an expensive gift or party will not scar anyone haha